Article

Can point of care (POC) testing for Sexual Transmitted Infections (STIs) ever be cost-effective?

cost effective sti testing

Increase Efficiency, Reduce Costs: The Value of Point-of-Care (POC) STI Testing

The Cost-Effectiveness of Point-of-Care Testing (POCT) for Common Sexually Transmitted Infections

Sexually transmitted infections (STIs) represent a significant global public health challenge, with millions of cases occurring each year.1 Timely diagnosis and treatment are critical to breaking the chain of transmission and preventing complications.1 In recent years, point-of-care (POC) testing has emerged as an innovative approach to STI diagnosis, offering rapid, accurate results at the site of patient care. While POC tests are often praised for their clinical and logistical advantages, they may also hold significant potential for cost-effectiveness compared to conventional laboratory-based testing methods.2

This article examines the cost-effectiveness of POC testing for common STIs, focusing on Chlamydia trachomatis (CT), Neisseria gonorrhoea (NG), and Mycoplasma genitalium (MG). 

 

The Economic and Clinical Burden of STIs

STIs impose considerable socioeconomic costs through direct healthcare expenditures and indirect costs such as lost productivity and reduced quality of life.3,4 For example, untreated CT, NG or MG can lead to pelvic inflammatory disease (PID), ectopic pregnancies, and infertility, increasing the long-term costs of care.3,4,5 The prevalence of asymptomatic cases further complicates matters, as many individuals remain undiagnosed and unknowingly contribute to transmission.1 Early and efficient diagnostic strategies, therefore, have the potential to help improve both individual health outcomes and economic efficiency.

 

The Advantages of Point-of-Care Testing (POCT)

POC testing refers to diagnostic tests designed to deliver rapid results. These tests are usually administered during a patient’s visit to a healthcare provider or at community-based testing sites.6 

POC testing has several advantages over traditional lab-based methods:

  1. Reduction in Time-to-Treatment: By providing actionable results during a single appointment window, POC tests may help reduce the traditional delays in treatment initiation while clinicians await laboratory testing results.6 With the opportunity to deliver appropriate treatment at the first appointment, this may reduce the need for patient recall, freeing up clinic time. 

  2. Improved Patient Management: At-risk patient groups, who could be at high risk of loss to follow-up, may be screened and treated during a single healthcare visit.7

  3. Accessibility in Low-Resource Settings: POC tests do not require transportation to central labs, making them particularly valuable in rural or underserved areas.

From a cost-effectiveness perspective, these advantages may help reduce the long-term costs associated with untreated or delayed-to-treat infections.

 

 

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The Health Economic Model: What You Could Achieve with POCT for STIs

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 Potential Clinical Benefits*:

  1. Time to result may be reduced from 5 days to approximately 20 minutes, helping to enable same-day diagnosis and treatment.8,9

  2. With actionable diagnostic results delivered in just 20 minutes, clinics may see up to an estimated 96% reduction in unnecessary antibiotic prescriptions. This reduction can help to support improved antimicrobial stewardship.

  3. Rapid diagnosis and treatment at the POC has the potential to treat patients earlier, helping to prevent continuing symptoms, development of complications and loss of at-risk patients to follow-up. This may lead to a projected 85% fewer PID cases.

  4. An estimated 100% elimination of patients lost to follow-up, avoiding untreated infection progression and onward transmission.

  5. Projected 32% reduction in overall clinic appointments, due to the potential reduction in follow-up appointments when patients receive appropriate treatment during their initial appointment. This may enable clinics to free up specialist capacity to improve services and introduce other innovative sexual health initiatives.

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Potential Cost Savings*:

  1. Total cost saving of £57,316 for the 10,000-patient cohort (5% reduction overall).

  2. £160,797 potential savings with a reduction in the number of follow-up appointment costs.

  3. Treatment costs may be reduced by 37%

  4. PID-related treatment costs may be cut by 85% 

While the cost of POC testing is higher than that of traditional laboratory testing, this rise in cost may be offset by substantial savings in downstream care.

*These outcomes are based on current assumptions, including 50% empiric prescribing in SoC, an equal gender split, consultant-led appointments, and conservative PID risk estimates. Real-world savings may differ.

Cost-Effectiveness Analysis: Key Factors

The cost-effectiveness and economic benefits of POC testing for STIs are related to the following factors:

1. Reduction in Transmission Rates

POC testing may help lower transmission rates by ensuring that infected individuals are promptly treated before spreading the infection to others.6 Prompt treatment for bacterial infections, such as CT and NG, may help reduce the community prevalence, improve public health outcomes, and decrease the overall burden on healthcare resources.

2. Reducing Complications

Untreated STIs can lead to costly complications such as PID, infertility, and neonatal infections.3,4,5 By facilitating same-day diagnosis and treatment, POC testing may help to reduce these sequelae. 

3. Reducing empirical treatment

Diagnostic delays, often spanning up to two weeks, may lead to increased prescribing of empirical antibiotics and may drive increasing antimicrobial resistance. This practice carries direct costs (the drug itself, managing potential side effects) and significant administrative overhead (multiple patient calls, tracking results, prolonged records management).10

4. Reducing Follow-up Costs

Conventional lab-based testing often necessitates additional healthcare visits to deliver results and initiate treatment. POC testing may help to reduce this need, reducing both patient transportation costs and healthcare system expenditures.

5. Broadening access to sexual health services

While the upfront cost of POC tests may be higher than standard lab tests, their portability and ease of use result in broader access and improved healthcare equity, driving long-term cost-effectiveness.2,7

 

Test while they wait, treat before they leave with rapid STI testing on the cobas® liat system

The cobas® liat system offers more than just rapid STI results from three common STIs in just 20 minutes; it may help to deliver cost-effective solutions for your clinic and your patients.

 

cobas-liat

Why Choose Point-of-Care Testing?

  • Helping to Reduce Patient Return Costs
    Reduce the financial burden of follow-ups. Up to 30% of patients don't return for treatment following a diagnosis.11 With same-visit results, start treatment immediately and minimise the risk of untreated STIs.

  • Helping to Minimise Indirect Costs
    This may help to avoid costs related to delayed treatment including complications, onward transmission, and reinfection, which can lead to higher long-term expenses for both clinics and patients.6

  • Helping to Optimise Clinic Workflow
    Rapid 20-minute results streamline diagnosis-to-treatment transitions, reducing bottlenecks in your patient flow and helping to free up resources for other priorities.

  • Helping to Support Public Health Goals
    Unchecked STIs lead to increased healthcare costs at both individual and societal levels. Providing timely treatment may help to enhance health outcomes while reducing the economic impact of prolonged infections.3,4,5,6

Conclusion

Point-of-care testing for common sexually transmitted infections offers a compelling case for cost-effectiveness, particularly when considering that its introduction may help to reduce transmission, prevent complications, and reduce follow-up expenses. While upfront costs may seem prohibitive in certain settings, the long-term economic and public health benefits could help to outweigh these initial investments. 

 

For further information on the Health Economic model used in this article please contact us.

 

References

  1. WHO, Sexually Transmitted Infections (STIs). Available at https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis). Accessed October 2025. 

  2. WHO, Laboratory and point-of-care diagnostic testing for sexually transmitted infections, including HIV technical document. Available at https://www.who.int/publications/i/item/9789240077089. Accessed October 2025

  3. Chesson, Harrell PhD; Spicknall, Ian H. PhD; Kreisel, Kristen M. PhD; Gift, Thomas L. PhD. Estimates of the Lifetime Productivity Costs of Chlamydia, Gonorrhea, and Syphilis in the United States. Sexually Transmitted Diseases 51(10):p 635-640, October 2024. | DOI: 10.1097/OLQ.0000000000001973

  4. Elendu C, Amaechi DC, Elendu ID, Elendu TC, Amaechi EC, Usoro EU, Chima-Ogbuiyi NL, Arrey Agbor DB, Onwuegbule CJ, Afolayan EF, Balogun BB. Global perspectives on the burden of sexually transmitted diseases: A narrative review. Medicine (Baltimore). 2024 May 17;103(20):e38199. doi: 10.1097/MD.0000000000038199. PMID: 38758874; PMCID: PMC11098264.

  5. Curran JW. Economic consequences of pelvic inflammatory disease in the United States. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 2):848-51. doi: 10.1016/0002-9378(80)91069-8. PMID: 7008601.

  6. UK Health Security Agency. STI prioritisation framework, Appendix 3. Available at: https://assets.publishing.service.gov.uk/media/6703c71fe84ae1fd8592eefa/appendix-3-supporting-information.pdf. Accessed October 2025.

  7. UK Health Security Agency. STI prioritisation framework. Available at: https://assets.publishing.service.gov.uk/media/67376f07abe1d74ea7dade2d/STI-prioritisation-framework.pdf  Accessed: October 2025.

  8. cobas® liat CT/NG/MG package insert 10147563190-01EN Doc Rev. 1.0 October 2024

  9. cobas® liat CT/NG package insert 10147580190-01EN  Doc Rev. 1.0  October 2024

  10. BASHH guidelines. Available at: https://www.bashh.org/resources/guidelines. Accessed October 2025. 

  11. Huppert JS, et al. Improving notification of sexually transmitted infections: a quality improvement project and planned experiment. Pediatrics. 2012;130(2):e415-22.