OBJECTIVES:

National strategies for preparedness on future outbreaks of COVID-19 often include the timely preparedness with available vaccines. Fiscal health modelling (FHM) has recently been brought forward as an additional analysis by defining the fiscal impact of a health condition from a governmental perspective. As governments are the main decision-makers on preparedness, this study assesses a FHM framework for a communicable disease.

METHODS:

Using data of the Dutch COVID-19 pandemic, two approaches for identifying the fiscal impact of COVID-19 were assessed: 1. modelling of future fiscal impact based on publicly available population counts; and 2. assessment of the extrapolated tax and benefit income and gross domestic product (GDP) in a particular time period with the respective realized values. The appropriateness of different modelling approaches was in line with the ISPOR FHM guidelines and extensively validated in an expert meeting.

RESULTS:

Dutch publicly available data was the basis for the analysis performed, showing total counts of 2.36 million infections, 52,678 hospitalisations, 9,805 ICU admissions and 9,493 deaths in a period of 24 months following the start of COVID-19 in 2020. Consequences which can be causally linked to these counts influencing income tax collected and social benefits paid (approach 1) amounted to a fiscal loss of €158 million over 2 years. The total losses in terms of the fiscal income and GDP (approach 2), were estimated at respectively €13,582 million and €96.3 billion over 24 months.

CONCLUSIONS:

This study is a full integrated fiscal macro-economic orientation to analyse different aspects of an infectious disease outbreak and its influence on government public accounts. The suitability of the two presented approaches depends on the perspective of the analysis, time horizon of the analysis and availability of data. The consequence-linking approach is more suited to a prospective estimation and the extrapolating approach more to a retrospective one.