LABORATORY TEST

COSTING TOOL
–
USER MANUAL/TRAINING
MANUAL
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Document number: WHO/EURO:2019-3484-43243-60604

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 Laboratory Test Costing Tool User Manual

Contents
Abbreviations ............................................................................................................................. ii

Introduction ............................................................................................................................... 1

Purpose ...................................................................................................................................... 1

Presentation of the tool ............................................................................................................ 1

Data Entry Results worksheet ............................................................................................... 2

Reagents and Consumables worksheet................................................................................. 2

Equipment worksheet ........................................................................................................... 2

Personnel worksheet ............................................................................................................. 3

Facility worksheet.................................................................................................................. 3

Quality Management worksheet........................................................................................... 3

Method used to calculate the cost of a test.............................................................................. 3

How to use the tool ................................................................................................................... 4

Data entry and results worksheet ......................................................................................... 5

Reagents and Consumables worksheet................................................................................. 7

Equipment worksheet ........................................................................................................... 9

Personnel worksheet ........................................................................................................... 11

Facility worksheet................................................................................................................ 11

Quality Management worksheet......................................................................................... 12

Language worksheet............................................................................................................ 12

Note ......................................................................................................................................... 12

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 Laboratory Test Costing Tool User Manual

Abbreviations

BLBH Better Labs for Better Health

ELISA Enzyme-linked immunosorbent assay
EQA External Quality Assessment
IQC Internal Quality Control
HR Human resources
IHR International Health Regulations (2005)
LFM Laboratory Financial Minute
LTCT Laboratory Test Costing Tool
PAT High Threat Pathogens Team
SOP Standard Operating Procedure(s)
QC Quality Control
QM Quality Management
WHE World Health Emergency Programme
WHO World Health Organization

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 Laboratory Test Costing Tool User Manual

Introduction
In alignment with the Maputo Declaration on Strengthening of Laboratory Systems and the Health
2020 European Policy for health and well-being, the WHO Regional Office for Europe launched the
Better Labs for Better Health initiative in 2012. This initiative is an intersectoral approach aimed to
improve the quality of laboratory services and it is a principal part of WHO’s efforts to assist Member
States to accomplish their commitment under the IHR core capacity implementation. Better Labs for
Better Health builds on the premise that sustainable laboratory services require a rational approach
to laboratory system strengthening. A crucial component of an efficient laboratory system is having
a comprehensive overview on laboratory expenditures and actual cost of tests.

Better Labs for Better Health advocates for clear organization of laboratory systems at all
hierarchical levels within a country, including the development of clear terms of references, tests
and methods for each level. To support this, Better Labs for Better Health has developed the
laboratory test costing tool (LTCT) to help laboratories evaluate the cost of a specific laboratory test,
justify this cost and produce pricelists for laboratory tests.

Purpose
The LTCT is designed to calculate the cost of a specific laboratory test. The LTCT can be used by
various professionals including:

• policy-makers;
• health economists and administrators;
• Ministry of Health (MoH) representatives; and
• laboratory directors, coordinators and quality managers.

Presentation of the tool

The LTCT is an MS Excel™ spreadsheet with six worksheets.

Fig. 1: Worksheets in the LTCT

Altering or renaming worksheet names, cell labels or protected fields can result in calculation errors
and possibly compromise the interpretation of the data. Any changes to these parameters should
only be made by the Better Labs for Better Health development team.

A language selector allows the tool to be displayed in English, French, Russian and Ukrainian.

The How to use the tool section of this guide provides an example of how to enter data in the LTCT.

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 Laboratory Test Costing Tool User Manual

Data Entry Results worksheet

You use this worksheet to enter all general data and laboratory variables for the calculation of the
cost of the test – for example, the currency to be used.

You also use this worksheet to change the language of all the worksheets. English, French, Russian
and Ukrainian are currently available.

Fig. 2: Language selection

Click on the yellow language cell to activate the selector arrow to open the drop-down list of
languages.

Changing the language does not change the tool’s functionality in any way.

Reagents and Consumables worksheet

You use this worksheet to calculate the costs of reagents and consumables, and to gather
information concerning procurement (ordering reference) of reagents and supplies used in the
laboratory.

This worksheet describes the number of units in one package of reagents and the number of units
used for each patient sample. This allows you to calculate the price of reagents and consumables for
a patient’s test, which will be added to the total costs.

The worksheet also contains information on Quality Control (QC) and Calibrators and estimates the
number of tests used to run QCs and calibrations.

The costs of all consumables such as gloves, masks, gowns etc. are entered using this worksheet.

Equipment worksheet

You use this worksheet to specify equipment costs (acquisition price) and status (number of service
years (year expected for equipment to be used for testing), its identification and costs of
maintenance.

This worksheet is divided into General equipment (e.g. biosafety cabinets, thermostats, automatic
pipettes, refrigerators etc.) and test-specific equipment (e.g. PCR machines, various analyzers,
microplate washers, microplate readers (spectrophotometer)).

The worksheet automatically calculates the annual amortization value of the equipment, the
equipment use price per day and the per laboratory financial minute (LFM).

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 Laboratory Test Costing Tool User Manual

Personnel worksheet

You use this worksheet to calculate the cost of the total number of personnel involved in performing
specific tests and all the related personnel costs.

An additional 20% is added to the total cost of personnel to cover administrative personnel costs,
such as:

• Administrative and management personnel

• Quality and biosafety managers
• Laboratory director
• Human resources personnel

In the tool, the percentage can be adjusted. It is up to the users’ discretion to add the cost for
administrative personnel.

The user can use the actual size and profile of the laboratory and type of organization to adjust
estimation.

Facility worksheet

You use this worksheet to calculate costs related to the facility, e.g. rent, maintenance, gas and
heating, water, electricity and communications.

Quality Management worksheet

You use this worksheet to calculate the cost of quality management, including costs of proficiency
panels and annual audits.

Method used to calculate the cost of a test

The LTCT uses the Laboratory Financial Minute (LFM) as a measurable unit to estimate the cost of a
test. The tool uses the Equipment, Personnel and Facility worksheets to calculate the cost of 1 LFM.

Explanation of Formula: The cost of a single test is estimated as the sum of the Cost of 1 LFM for
Equipment, Personnel and Facility, multiplied by the calculated LFM value for the test added to the
cost of R&C and QM for the test. See the example of calculations in How to use the tool.

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 Laboratory Test Costing Tool User Manual

Fig. 3: Formula for cost of test

Cost of
1 LFM equipment reagents and
+ consumables (1 test)
1 LFM personnel
Calculated LFM value
+
for 1 test
+ Cost of quality
1 LFM facility management
(1test)

The Reagents and consumables (R&C) and Quality management (QM) worksheets do not use LFM,
but calculate the cost of a single test based on the total costs of inputs.

How to use the tool

Table 1 describes the colour-coding of the cells in the LTCT.

Table 1: Colour-coding and content of the LTCT data cells

Tool: Colour legend

Black Fixed titles and totals
White General information and legends
Grey Automated calculations – protected
Blue Data to be entered by user
Green Reference data to be entered by the user

Cells coloured in green in the user manual are reference data cells – these cells are for the user to fill
in for quality purposes and they will not affect the formulas and calculations but are there for your
laboratory to look back to for reference in the future. Although this data is not mandatory to use the
tool, this can be used as a reference for quality management reasons.

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 Laboratory Test Costing Tool User Manual

Data entry and results worksheet

The Data entry and results worksheet contains two tables – the Data entry and Results tables:

• Enter all necessary data and numbers in the blue cells in the Data entry table.
• The Results table contains only grey cells, which the user cannot enter data in (they are
protected). These cells automatically use the formula described above to calculate the cost
of a single test based on the data entered into the worksheets in the LTCT.

Table 2: Entering data in the Data entry table

Data entry table Helpful Hints and Examples

Name of test e.g. Brucella

Year Optional data
Testing area Optional data
(scope)
Intended use Optional data
Sample type Optional data
Method Optional data
Commercial (or in Optional data
house) test kit
Time needed to Enter the time (in minutes) to How much time does it take to do the
run one testing perform one testing batch analysis of this test?
batch (testing run). This is actual Remember, if the laboratory is
(minutes) working time of the technician responsible for pre- analytical work, the
and/or specialist. It can be time it takes to do that is added here, if
estimated according to the not, only put the time it takes to do the
Laboratory Testing User Manual analytical part of the test. Enter the
/testing SOP description. number in minutes.
Lab Working Enter the number of working How many hours a day is your laboratory
Hours per day hours per day. open?
Enter in hours. Ex: 8
Lab Working Days Enter the number of working How many working days is your
per year: days per calendar year. An laboratory open in a whole year?
accounting/ financial calendar For example:
can be used. This can be
Usually it is 240 days, not accounting for
estimated using the laboratory
holidays. If the laboratory is open on
“opening-hours” profile (e.g.
weekends, account for these days as
24/7 duty, Mon-Fri, Mon-Sat).
well.

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 Laboratory Test Costing Tool User Manual

Lab Working Enter the number of working How many working weeks is your
Weeks per year: weeks (usually 50-52). laboratory open in a whole year?
Divide how many days you are open in a
whole year and divide by how many days
in the week you are open.
For example: 240 (open days a year) /
5 (open days a week) = 48 weeks
Testing schedule Enter the number of times you How many times do you perform test
(times per week) perform the test in the week. per week?
Ex: Twice a day for 5 days = 10 runs
Number of testing This cell is automatically The formula for this cell is C17 * C18
batches (runs) per calculated. C17 Lab working weeks multiplied by
year C18 testing schedule per week
For example: 48 weeks * 12 times a
week = 576 times that I run this test per
year
Take note that sometimes batches have
multiple samples.
Batch definition: A group of up to 20
samples, sample extracts, or (including
QC aliquots) depending on the test, that
are analyzed together on the same
instrument.

Mean of tests per Enter the number of tests per Remember to put the number of tests
years year of this specific test. you get per year for this specific test.
This can be estimated by taking For example: My laboratory received
the mean number of tests for the Year 1 – 1500 HIV samples
past three years. Year 2 – 2500 HIV samples
Year 3 – 1000 HIV samples
My answer would be: 5000 / 3 = 1666.67
On average the mean of tests per years
for HIV in my laboratory is 1667

Currency Enter the local or international Remember to use this currency for all
currency. costs throughout the tool
The LTCT displays the calculated value of the Lab Financial Minutes (LFM)1 for a single test and the
total cost of a single test2 in the Data entry and results worksheet.

1 Data Entry & Result Cell C26

2 Data Entry & Result Cell C33

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 Laboratory Test Costing Tool User Manual

Reagents and Consumables worksheet

Table 3: Entering data in the Reagents and consumables worksheet

Here we describe how to enter the data in the Reagents and consumables worksheet

Reagents and consumables worksheet

Category Enter the category of

reagent or the name of the
consumable.
Ordering Reference Enter the ordering reference
for reagent or consumable.
Name of reagent or Enter the commercial
consumable name/manufacturer.
Number units per package Enter the number of units How many units are there per
per kit/package/box. package or box?
Package price Enter the price.
Unit used per patient sample 1) Enter the number of How many units do you use for a
reagent units used for a single patient test?
single patient test. Reagent
units can be estimated
For example:
according to the Laboratory
For consumables that are not for
Testing User Manual /testing
one time use only. Make sure
SOP description.
that you accurately calculate the
2) Enter the consumable
amount by using the calculation
units. These can be
below.
estimated according to the
testing method/technology,
according to laboratory If you can use this consumable
biosafety practices and 2x per patient sample put 0.50
internal SOPs. for units used per patient
sample.
1 unit / 2 times = .50 units used
per patient sample
1 unit / 50 times = .02 units used
per patient sample

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 Laboratory Test Costing Tool User Manual

QC Enter the number of QC Only enter data here if it is not

per 1 batch (run) units used for a single testing included in test kits
batch (run). QC units can be
estimated according to the
Laboratory Testing User
Manual /testing SOP
description.
Calibrators Enter the number of
per 1 batch (run) calibrator units used for a
single testing batch (run).
Calibrator units can be
estimated according to the
Laboratory Testing User
Manual /testing SOP
description.

Quality Control - the use of control materials to monitor the accuracy and precision of all the
processes associated with the examination (analytic) phase of testing3.

Calibrators - are solutions with a specified defined concentration that are used to set or calibrate an
instrument, kit, or system before testing is begun. Calibrators are often provided by the
manufacturer of an instrument4

3https://apps.who.int/iris/bitstream/handle/10665/44665/9789241548274_eng.pdf;jsessionid=400E8

D69C192B279B3C1E954CA48384D?sequence=1(Page 75)
4https://apps.who.int/iris/bitstream/handle/10665/44665/9789241548274_eng.pdf;jsessionid=400E8

D69C192B279B3C1E954CA48384D?sequence=1(Page 79)
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 Laboratory Test Costing Tool User Manual

Equipment worksheet

Table 4: Entering data in the Equipment worksheet

Equipment Worksheet

Identification General Equipment: Enter the

type of general equipment.
This equipment is not test-
specific and can be used for
different methods.
Specific Equipment: Enter the
type of test-specific
equipment. This equipment is
essential for test performance.
Information can be taken from
the Laboratory Testing User
Manual /testing SOP.
Name/Manufacturer Enter the commercial name
and manufacturer.
Acquisition price (without tax) Enter the acquisition price. Any equipment donated to the
laboratory should still have an
estimated price to account for
amortization for future
equipment.

Example:
If a donated equipment can
have a lifetime of 5 years, the
price placed here will give the
laboratory an opportunity to
allocate some cost for
purchasing the next equipment
after 5 years.

Number of years Enter the expected lifetime of How long will you be able to
the equipment. The estimated use this equipment for?
number of years the Indicate number in years.
equipment will be in use
according to national
legislation or the
manufacturer’s description.
Maintenance contract cost per Enter the cost of maintenance
year as specified in the contract.

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 Laboratory Test Costing Tool User Manual

% of use for method /day Enter %. This can be estimated Data needed in minutes:
according to the number of A: Time needed to run one
tests and methods used on testing batch (minutes), this is
the same item of equipment. the data entered in the Data
Entry and Results page cell
B14.
B: Total time used for this
equipment for all methods per
day. Add the different time
need to run one testing batch
for ALL methods in this
equipment.
Formula:
A / B * 100 = % of use for method per day
Example:
I want to calculate the % of use for method per day for my ELISA
machine for HIV testing in my laboratory.
The time needed to run one testing batch for HIV is 40 minutes
(A).
I use my ELISA machine for 4 different types of testing per day
• HIV – 40 minutes
• Hepatitis C – 30 minutes
• Hepatitis B – 100 minutes
• E.Coli – 120 minutes
The total time used for this equipment for all methods is
40+40+ 100+ 120= 290 minutes per day (B)
40/290*100 = 13.79%

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 Laboratory Test Costing Tool User Manual

Personnel worksheet

Table 5: Entering data in the Personnel worksheet

Personnel worksheet

Category of laboratory Enter (list) the Remember to enter salaries that you
personnel personnel involved in want to be accounted in the cost of a
testing individually. specific test.

Example: If the head of the laboratory is

paid by the state, their salary should not
be included here.
Personnel identification Enter the name of the
member of personnel.
Annual salary Enter the personnel
member’s annual salary
including taxes.

Facility worksheet

Table 6: Entering data in the Facility worksheet

Facility worksheet

Monthly Rent cost Enter Facility costs should be based on data

gathered by the accounting office.

Remember to enter facility costs that

you want to be accounted in the cost of
a specific test. This is up to the user’s
judgement.

Building maintenance Enter

costs/month
Gas and heating cost/ Enter
month
Water cost/ month Enter
Electricity cost/ month Enter
Internet/telephone Enter
Other costs Enter any other facility
costs not specified
above.

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 Laboratory Test Costing Tool User Manual

Quality Management worksheet

Table 7: Entering data in the Quality management worksheet

Quality management worksheet

Quality Management Enter different quality management activities such as proficiency

Activities testing or annual auditing

Price Enter the price of the activities

# total number of methods Enter the number of methods that were inspected during the
being audited audit.

Language worksheet

Any modification of the wording in the module’s worksheets should ONLY be done in the Language
worksheet, because the cells in the other worksheets refer to cells in this worksheet. This worksheet
is hidden; changes to cell labels etc. can therefore only be done by the Better Labs for Better Health
development team.

Note
Your changes and improvements may be of interest to us as this is still a developing project. We
kindly ask you to send us your new version or revised version to the following email addresses:
[email protected]

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Office for Europe

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