Under new RT-PCR rates, private labs may cut corners

State has brought down rates for the test from K1,700 to K500 
For representational purposes
For representational purposes

KOCHI: Private labs across the state were reluctant to bring down the RT-PCR test rates to Rs 500 saying the new lower rates are not viable, a day after the government brought down the rates from Rs 1,700 to bring them on par with the prices prevailing in other states.

While many private labs stopped testing samples for Covid on Friday, in Alappuzha AIYF workers held a protest demonstration outside a private lab after it continued to charge Rs 1,700 per RT-PCR test. One private lab in Kasaragod suspended the RT-PCR test and another bigger lab said it will continue to test but disagreed with the government’s pricing. 

“The price cap (Rs 500/test) will prevail. The government will take further action to ensure the compliance of its order,” said Chief Minister Pinarayi Vijayan in his daily presser.  T A Varkey, former president, Medical Laboratory Owners’ Association, said doing an RT-PCR test for Rs 500 was not viable for a private laboratory. “This is because the reagent used for the test itself costs Rs 600. Besides this there is the cost of salaries paid to technicians. Twice or thrice the amount is paid to regular technicians,” he said.

Added a lab owner in Kasaragod district: “The government went by the reagent cost but a lab is more than the reagent used for a test.” He said he has employed two doctors who are specialists in pathology and microbiology. The tests are done by those who have PhD or post-graduation in molecular biology. Further, a PCR machine costs anywhere between Rs 10 lakh to Rs 19 lakh and the RNA extraction machine cost Rs 6 lakh to Rs 10 lakh, he said.

Kerala Private Medical Laboratories Owners Federation (KPLOF) state secretary Abdul Azeez said the association will hold its state committee meeting on Saturday to discuss the issue. C Balachandran, Jeeva Speciality Laboratory, Thrissur, said private labs would not be able to manage beyond three days under the new lower rates set by the state government. 

Officials of private labs said though they may have made a 30-40 per cent profit at Rs 1,700 per RT-PCR test, the margin did not include their huge capital investment. “Anywhere between Rs 800 to Rs 1,000 would have been viable,” said one private lab owner. Another lab owner said RT-PCR testing is labour-intensive work and labs end up paying overtime to workers because they come in early and leave as late as 3 am. “We have five workers to enter data of customers onto the government portal,” he said. As per rules, a positive sample has to be stored at minus 80 degrees Celsius for two years. “A 100-litre -80 (degrees Celsius) fridge costs at least Rs 5 lakh. On top of that comes the power bill,” he said.

He said labs that do test for less than Rs 500 cut corners by employing underqualified persons to collect samples and running up to 10 samples together in a PCR machine. For an antigen test, swabs should be collected from both the nostrils, and for RT-PCR tests, swabs should be collected from both the nostrils and throat to get the right viral load. “How many are doing it? Also if the client feels no discomfort after the swab is taken, it was not done right and the result will likely be negative,” he said.

There are 96 wells (small depressions) in a plate kept in the PCR machine. “Ideally, only one sample should be kept in a well. But labs mix two to 10 samples in one well and run the test,” he said. If there is no positive, the labs save around Rs 400. But if one well throws up a positive result, they will have to do an independent test on all the 10 samples. “Some labs will ignore such results and declare all as negative or do antigen tests on the 10 samples to save money,” he said. An antigen test kit costs only Rs 100.
If such practice becomes widespread, Covid cases will become widespread in the state, said the lab owner.

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