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APHA Scientific Session and Event Listing

Susan Garfield, MSc, SM¹, Johanna Morfesis, MSN, NP², Helaine Bader, MPH³, Vanessa Cullins, MD, MPH, MBA², Julie Altier², and Jennifer Lamb-Taylor³. (1) Women's Health Department, Digene Corporation, Boston University School of Public Health, Maternal and Child Health, 156 Fifth Street, Boston, MA 02141, 617-868-5246, susan.garfield@digene.com, (2) Medical Affairs, Planned Parenthood Federation of America, 434 West 33rd Street, New York, NY 10001, (3) Women's Health, Digene Corporation, 1201 Clopper Road, Gaithersburg, MD 20878

Background: Molecular diagnostics offer great promise in improving the accuracy of screening for cervical cancer and sexually transmitted infections; however, fiscal constraints often limit public health providers' ability to offer them to their patients. To study the impact of financial realities on technology adoption and to determine the feasibility of incorporating these new technologies into public health settings, a cost study was conducted. Methodology: Three PPFA affiliates representing diverse geographic and demographic populations, were chosen to participate. Each completed a survey on HPV, Pap, Chlamydia and Gonorrhea testing costs, fees to laboratories, payer mix, average reimbursement rates, and composition of self-pay programs. The data were analyzed to assess how cost and infrastructure issues relating to each test impacted the feasibility of adoption of testing methods within each affiliate. Results: Significant variability in testing practice exists across affiliates. Variation was pronounced in the prices that affiliates pay for Chlamydia (CT), gonorrhea (GC), Pap and HPV testing. For example, HPV test prices were higher than the national Medicare average reimbursement for some affiliates. Pricing structure, rather than population make-up or clinical preference, seems to be the key driver of the variation in testing practice. Conclusion: Opportunity exists for lower priced testing for cervical cancer and other sexually transmitted infections. These opportunities can be maximized by working with motivated laboratories, and potentially standardizing practice across affiliates. Further data is needed to identify the price at which HPV and other advanced testing could be widely offered across the PPFA network.

Learning Objectives: