We appreciate Dr Benjamin's interest in our cost-effectiveness analysis of managing children with sore throats. We would like to emphasize that we did indeed include personnel costs, but only the variable costs of personnel time, ie, only those personnel costs directly attributable to each additional test performed. In general, costs of CLIA inspections and proficiency testing should only be included if they are directly related to the volume of tests performed, in which case only the variable cost for each test should be included. Such costs would likely be most applicable to the office-based testing strategies, and in particular, to office-based throat cultures and certain rapid antigen tests since they are not waived by CLIA.
Tsevat J, Kotagal UR. The Costs of Testing for Streptococcal Pharyngitis in the Office Laboratory. Arch Pediatr Adolesc Med. 2000;154(1):94. doi: