‘Stance on testing coloured by profit’

Private pathology giants have been accused of cartel-like behaviour in refusing to endorse alternatives to PCR Covid testing.

Private pathologists remain vehemently opposed to endorsing any alternatives to PCR testing. Picture: Gaye Gerard

Private pathology giants have been accused of cartel-like behaviour in refusing to endorse alternatives to PCR Covid testing, unwilling to forgo huge profits in Medicare rebates since the start of the pandemic.

Private pathologists remain vehemently opposed to endorsing any alternatives to PCR testing, which generate a $100 Medicare rebate per test. Rapid antigen tests range from $10 to $15 per test but are not covered by Medicare.

In NSW, PCR tests have cost the taxpayer more than $500m since the start of the pandemic. But many medical specialists believe much cheaper rapid antigen tests should be urgently rolled out for schools, aged-care facilities, manufacturing workers, border staff and hospital workers.

Specialist emergency physician Ian Norton said it was inappropriate that pathology groups would have influence over any public health decision in favour of rapid antigen testing, and has called for an independent group to be appointed to review their use and benefits.

Dr Norton is a former head of the World Health Organisation’s emergency medical team who helped advise the commonwealth on the management of the Howard Springs quarantine facility.

He said pathology labs were relying on out-of-date science and reasons which were applicable when there were low rates of community transmission.

“We absolutely need to have a conversation about cost,” he said. “The PCR test has a rebate of $100 and a cost point of $80, and rapid antigen testing is in the $10-$15 bracket and not covered by a ­rebate. The margins are less, it’s a commercial fact.

“It is inappropriate that lab networks should influence against point-of-care testing for reasons that would not be as valid as they were six months ago. The science has changed and the science is emerging.

“These are TGA-approved tests used in many other countries. Now when we have outbreaks occurring we need to rethink the advice just like ATAGI did for vaccines.

“We need to have an independent group that looks at this from an emergency management point of view, not from a purely laboratory point of view.”

The heavily concentrated Australian pathology market is controlled by two major providers – Healius and Sonic Healthcare – which have both earned huge revenues through Medicare-rebated Covid PCR testing.

The PCR test has long been dubbed the “gold standard” in Australia. It is a highly sensitive and effective method of detecting positive cases. But there is a growing body of evidence that supports use of rapid antigen testing, which works by detecting proteins found on the virus. The point-of-care tests are inexpensive, don’t require specialist lab equipment and return a result in 10 to 15 minutes. When used frequently, experts say they can be a useful tool as part of a wider outbreak management strategy.

As the Sydney outbreak continues to rage, the state’s PCR testing capacity has become overwhelmed, with reports of people waiting up to 100 hours to receive a result. This has led to renewed calls for rapid antigen testing.

Sonic Healthcare sales boomed 33 per cent in its most recent half-yearly result, with ­organic sales in its Australian labs growing by 26 per cent from Covid testing. Healius also returned stellar results, with pathology sales jumping 22 per cent and underlying net profit after tax surging by 190 per cent.

The Royal College of Pathologists of Australasia last week ramped up its war footing against the alternative tests, releasing a statement that questioned their reliability in low prevalence settings and their propensity to return false negative and positive results.