OBJECTIVES: The Novel Coronavirus (COVID-19) has infected millions worldwide and caused hundreds of thousands of deaths. Many countries are fast-tracking the development of treatments and vaccines to address the pandemic. We sought to analyze the cost-effectiveness and budget impact of hypothetical technologies for COVID-19.

METHODS: We constructed a Markov model of COVID-19 infection using Susceptible-Exposed-Infected-Recovered (SEIR) structure over one-year from a U.S. societal perspective. The model consisted of four comparators: do nothing, social distancing, COVID-19 treatment or vaccine. Hospitalization and mortality rates were calibrated to U.S. COVID-19 reports as of April 2020. We performed economic calculations of costs in 2020 U.S. dollars and effectiveness in units of quality-adjusted life years (QALYs) to measure budget impact and incremental cost-effectiveness at a $100,000/QALY threshold.

RESULTS: Treatments and vaccines have high probabilities of reducing healthcare costs and increasing QALYs compared to current alternatives. Simulations showed reductions in hospital-days and mortality by more than 50%. Even though this represents a major U.S. investment, the budget impacts of these technological alternatives could save costs by 90% or more even if uptake is high.

CONCLUSIONS: Investing in disruptive vaccines or treatments to mitigate COVID-19 infection offer high-value potential that societies should consider. Unusually high uptake in these technologies in a short amount of time could result in unprecedented budget impacts to government and commercial payers. Governments should focus on expanding health system infrastructure and subsidizing payer coverage to deliver treatments or vaccines efficiently within the U.S. as soon as possible.