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Opinion: The government should ensure payment for at-home COVID-19 testing

The CEO of telehealth company Hims & Hers, which is coordinating efforts with the F.D.A., argues that affordable home testing will unburden the health system—and help get the economy going.

Opinion: The government should ensure payment for at-home COVID-19 testing
A COVID-19 IgG and IgM Rapid Test Cassette is displayed on April 16, 2020 in New York City. The take home test says they can tell a person if they have Coronavirus antibodies in their system, thus indicating that they have had he virus. [Photo: Spencer Platt / Staff/Getty Images]
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At-home testing for COVID-19 is crucial for controlling the virus in the United States, which has become the epicenter of the global pandemic. As of writing this, more than 760,000 cases have been confirmed (and that number will have only grown since publication).

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Articles by medical professionals started appearing back in early March, in both the Journal of American Medical Association and Harvard Business Review, detailing how testing in mass numbers across multiple avenues was critical, specifically pointing to the importance and benefits of telemedicine and at-home testing to increase capacity. However, our country’s inability to obtain and distribute these tests has been one of the biggest challenges in containing COVID-19’s spread.

But even once we have more testing options, such as patient self-collection at home, the pressing issue of how Americans will pay for them still remains. For even the most efficient labs, current costs for at-home test kits can range anywhere from $150-$300 per result. Given the current price structure, it is imperative that the government find a way to ensure every American can afford to get tested. The most effective way to do that is to reimburse for the cost of testing—either through health insurance plans or directly from the government. With unemployment figures growing rapidly, tens of millions of Americans will be uninsured, only exacerbating the issue.

This approach is the only way private labs can perform these tests without incurring financial ruin, and keep our healthcare system unburdened. At-home tests decrease our dependence on Personal Protective Equipment usage, including masks, gloves and gowns—keeping our communities inside and reducing the strain on our medical professionals. Widespread testing will ensure that we can return to daily life and work as soon as possible. Testing is the essential first step to reopening the country in a safe and timely manner.

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At Hims & Hers, we are working with a network of certified and accredited labs and coordinating with the FDA to ensure that we can create access to these tests for the American people. (Earlier this week the FDA granted emergency clearance for an in-home COVID-19 test, which first will be made available to frontline and healthcare workers.)  Through our existing infrastructure, Hims & Hers has the ability to connect patients with at-home testing kits and access to medical providers to oversee the testing. We are one of a number of telehealth services working to amplify testing, both now as we continue to focus on flattening the curve, but more importantly, as we prepare for stay at home mandates to be lifted.

Our intention had been to provide access to these tests at no cost to patients. Despite the fact that federal health agencies have promised tests for anyone who wants them, the math to provide COVID-19 testing free of charge isn’t there. To simply cover the cost of one COVID-19 test, patients would need to pay an estimated $130: $80 for the lab’s production of the kit, $20 for the cost of the medical provider to oversee the self-collection, and $30 for shipping (because it’s a biohazardous material).

At-home tests under supervision of a healthcare provider can serve as a critical way to understand the spread of COVID-19. Through telemedicine platforms, doctors and medical professionals can order tests for symptomatic patients. They can oversee self-collection tests remotely. Patients will overnight the tests back to the CAP-accredited and CLIA-certified testing labs that are working toward running approximately thousands of tests per day. Healthcare providers working through telemedicine platforms will typically be able to obtain and share results and next steps with the patient within 48-72 hours after the lab receives the testing kit back from the patient.

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Telemedicine serves a vital role in patient care, especially during this pandemic. It has allowed patients to receive affordable, convenient care, and minimize the risk of spreading the virus. At the end of 2019, more than one million medical visits had taken place through the Hims and Hers platform. In the past few weeks, that has only continued to grow. Patients have used our new primary care offering, which launched less than a month ago, across 29 states. These patients are experiencing cold and flu symptoms, skin concerns, and allergies; all issues that can often be treated remotely. By keeping one more person at home, we prevent one more person from potentially contracting or spreading COVID-19 in a doctor’s office.

Given that a record 22 million Americans filed for unemployment in recent weeks, many citizens cannot afford these tests. Even in strong economic times, these tests would be too expensive. Additionally, public access to COVID-19 testing is already unequal: the powerful and privileged can easily be tested while at-risk populations cannot. At-home testing should solve this problem, not perpetuate it.

It’s been heartening to see the private sector step up in the absence of federal leadership during this time. Fashion companies are making masks and gowns for frontline healthcare workers. Distilleries and beauty companies are producing hand sanitizer. And private citizens have secured machines for treating sleep apnea as intermediary substitutes for ventilators. Like other companies, we’re here to serve the public and help provide relief, not make a profit, during the pandemic.

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Unfortunately, it’s impossible for labs and companies like ours to scale at-home testing across the country without customers paying out of pocket. This is wrong. I’m imploring our elected officials to come together with health plans and private testing labs to ensure every American can afford to be tested. We are confident the FDA will do everything it can to ensure more testing options are available to consumers. Now it’s up to Congress to make them affordable—if not free—so we can get Americans the care they deserve.

Andrew Dudum is founder and CEO of Hims & Hers