This Review of the Abbott BinaxNOW COVID-19 Rapid Antigen Test is for the travel test, which must be purchased from eMed.
How to Buy Abbott BinaxNOW Tests for Travel
Unfortunately, the Abbott BinaxNOW tests that are available at drugstores, such as Walgreens and CVS, are not valid for international travel, since for travel, the test must be supervised. To buy a BinaxNOW test that can be used for the testing that is required for U.S. citizens and permanent residents returning to the U.S., you'll need to purchase at emed.com. You must purchase a packet of six tests, which at time of writing costs $150 + tax and $15 shipping. Including tax and shipping, that worked out to $30 per test for us, 6X the $5 cost of the test for healthcare providers when it was first launched in August 2020. In Germany, rapid COVID antigen tests cost ~$1, while in the UK 14 tests per person are provided free of charge. Unfortunately, a key reason why prices are so high in the U.S. is the lack of competition, which in turn is because the FDA regulates these tests as medical devices, with the myriad of clinical trials that slows down approval.
While the price was excessive, given what's available in other countries, at least the shipping, via FedEx, was fast. We ordered the tests on a Thursday and they arrived the following day, Friday. Note that if you plan to use the tests for travel, prior to returning to the U.S., double check with your airline that it accepts the BinaxNow test results, and don't open the test boxes, as they should only be opened after you're in a Zoom supervised call.
Abbott BinaxNOW Test Kit Expiration
Here's the problem: the emed Web site is terrible in terms of telling you when the tests you're ordering will expire. And that matters, if you're planning to use the tests for future international travel, especially if you need to postpone your trip. We ordered our tests in early September 2021, yet the test was manufactured in February 2021 and has an expiration date of October 5, 2021. Even with the FDA extension of the shelf life to 12 months when stored at room temperature (82 degrees F), our tests expire February 2022, well before one of the trips we planned to use them for. When buying, assume that your tests could expire (even taking into account the FDA extension) within 3-4 months.
In order to log into eMed for a monitored test, you'll need to create a Navica account. If needing to test a child, don't make the mistake we did and create an account for your child using his/her email. We did this (for some reason the Navica app doesn't prevent this, even though you enter in your child's birthdate, and it would be very easy to design it properly so that you get a message saying that only adults 18 and older can create accounts) and then, after getting into a monitored session, the monitor told us that we had to create an adult account and add him as a minor to our account.
Also be sure to either use password manager or write down your password somewhere, since in our test, the password reset function didn't work for us.
BinaxNOW Monitored Test and Results
After our struggles with the Navica App, which could have used better QA, logging into eMed and actually taking the test was a relative breeze. The first step is answering some questions, including whether you have the unopened test available, sanitized hands, and official ID.
Next we were informed that a proctor would be with us soon. We had less than a 1 minute wait both of the two times we sought to connect in September 2021, so it appears that, at least as of time of writing, eMed has fixed the issues with long hold times that were frustrating travelers in August 2021.
Once we were connected with the proctor, we were asked for ID, then instructed to open the BinaxNOW test, which we lay flat on the table, while angling our laptop camera so that the test was visible.
The test kit is on cardboard, approximately the size of a credit card, although a bit wider. After carefully opening the vial of reagent included in the kit, we placed 6 drops of it in the top hole (the one closest to the center of the test card). We were then instructed to open the swab (make sure to open the correct side, to avoid contaminating the swab itself) and to gently swirl it 5 times in each nostril, before threading it through the hole nearest the edge of the test card until it touched the top hole, where the reagent is.
After that, we were instructed to wait for 15 minutes.
When 15 minutes were up, we clicked through to the monitor to be guided in interpreting the test results, although at least in our case it was very clear that it was negative. The top pink line is the control line, which both negative and positive tests should have. Our results only had this line, indicating a negative result. A positive result has two lines, the top pink control line and an additional pink line below it.
Keep in mind that antigen tests such as BinaxNow are less accurate than PCR tests. While Abbott advertises a sensitivity of 91.7%, which would mean that out of 1000 people who have COVID-19, the test would correctly identify 917 of them, another study found that test sensitivity was only 74%, and for self-collected samples even lower: ~57%. Fortunately specificity (the likelihood of getting a false positive) is more accurate, 98.5-100%, so out of every 1000 people, typically 15 or fewer will falsely obtain a positive result, even though they don't have COVID-19.
For a test that's been available for over a year in the U.S., the Abbott BinaxNOW test disappointed in most respects. Yes, we were happy to get a negative test result, but the sensitivity of the test isn't great, the tests are over 4X more expensive than when they were first released, the tests expire much sooner than we expected and this wasn't disclosed before purchasing; our email about this went unanswered by the company, and the Navica account creation and login was error-prone and needed more quality assurance.
We'll pack these as backup when traveling abroad, for our required pre-travel test before returning to the U.S., but we certainly wish there were more competitors to drive quality higher and prices lower.
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