Zika Testing Not Yet Covered by Health Plans in Brazil

By Lise Alves, Senior Contributing Reporter

SÃO PAULO, BRAZIL – Although Brazilian health plan operators are required to cover costs of tests for the detection of dengue and chikungunya fever, the National Complementary Health Agency (ANS) has not made it mandatory for health plans to cover the test to detect the Zika virus.

According to the ANS, the presence of the virus, which is also transmitted by the Aedes aegypti mosquito may be detected by the exclusion of dengue and the chikungunya fever viruses along with clinical symptoms of the Zika virus.

The position by the government agency that the detection of the Zika virus can be done by exclusion and therefore should not be required to be covered by health plans has been criticized by many.

“It would be ok to use the dengue and chikungunha fever tests to exclude the Zika if there were no specific tests available,” Mariano Zalis, of the Rio de Janeiro Federal University (UFRJ) told O Globo. “But that is not the case. We can already make the diagnosis, be sure (of the contagion).”

Others have stated that exclusion of what the patient does not have does not mean the patient has Zika, “There is no certainty through exclusion,” said infectologist Marcos do Lago, professor at the Rio de Janeiro State University (Uerj). “It maybe another disease associated to another virus. An indication is not a guarantee.”

Analysts say health plans are weary of covering the costs of the PCR exam, which is essential to prove the presence of the virus due to the price of the test: R$350. Daily O Globo contacted the main health plan administrators operating in Brazil and found that only Unimed Rio de Janeiro covers the costs of the PCR exam for Zika.