Antigen or Molecular Testing: Which Should You Choose?

By Alison Adduono, Director of Marketing Communications

As a healthcare provider, you are presented with multiple options for SARS-CoV-2 (COVID-19) testing. The choice between send-out/lab-based PCR, rapid antigen tests, or various Nucleic Acid Amplification Test (NAAT) Point-of-Care (POC) methodologies depends on what best fits your facility's needs and ensures optimal patient treatment.

Rapid antigen tests are a popular choice among many providers, primarily because of their speed and cost-effectiveness, not to mention the attractive reimbursement rates currently available. However, lower costs do not necessarily equate to high quality. When it comes to diagnostic accuracy, antigen tests may fall short, particularly with their increased potential for false negatives at lower viral loads. This shortcoming means you might miss identifying some positive cases, which is a significant concern.

In fact, a study cited on the NIH website, which compared Roche Cobas sample results with one NAAT test and two antigen tests, highlighted this issue. The antigen tests had a substantial decrease in sensitivity (1.7% and 0%) at a Ct range of 32-40, whereas the comparator NAAT was at 81.4%. This further demonstrates the superior sensitivity and overall utility of molecular testing.

Therefore, while rapid antigen tests have their advantages, it is crucial to consider the broader context, including the potential for missed diagnoses, when using these tests in your healthcare practice. Molecular tests provide a higher degree of reliability, especially in cases where accurate diagnosis is critical for patient care.

Most, if not all, urgent cares, clinics, and other healthcare facilities now have access to various COVID-19 testing methods, including antigen tests, send-out labbased PCR and POC NAATs. The decision to use one technique over another can depend on several factors:

  • Cost of the test

  • Payment method (cash, insurance, or Medicaid)

  • Reason for test (symptomatic testing, travel requirements, patient preference, etc.)

  • Staff familiarity with the testing equipment

  • Availability of testing instruments

  • Test kit availability (e.g., stock levels)

  • Turnaround time for results 

If you are a diehard antigen test user, it is wise to consider incorporating a POC NAAT option into your testing algorithm. The advantage of POC NAATs is their ability to combine the high accuracy of molecular testing with affordability and convenience, offering quicker results than traditional send-out PCR tests— with positives in as little as 20 minutes. Additionally, they often come with reasonable reimbursement rates. So, if the patient is showing symptoms or believes they were exposed, and tests negative on the antigen test, a follow-up or “reflex” NAAT could be just what the doctor ordered. No pun intended.

For more information about COVID-19 POC testing, you can find valuable resources and guidance on the CDC website.

The AscencioDx® COVID-19 Test and Molecular Detector, a proud innovation of Anavasi Diagnostics, is produced in Redmond, WA, and is readily available for purchase. This advanced system does not simply offer NAAT results; it stands out for its affordability and reusability, with absolutely no contractual commitments or minimum purchase obligations. Opt for the AscencioDx platform and ensure not only the financial health of your practice but also reliable, high-quality patient care.

For more detailed information or inquiries, please visit our website or reach out directly to us at sales@anavasidx.com. Your path to superior testing solutions starts here.

Resources:

Where Speed, Efficiency, & Accuracy Align

The AscencioDx® Covid-19 Test and The AscencioDx® Molecular Detector have not been FDA cleared or approved, but have been authorized for emergency use by FDA under an EUA for use by authorized laboratories. This product has been authorized only for the detection of nucleic acid from SARS-CoV-2, not for any other viruses or pathogens. The emergency use of this product is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. § 360bbb-3(b)(1), unless the declaration is terminated or authorization is revoked sooner.

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