OBJECTIVES:

The COVID-19 pandemic has a major impact on our society, with drastic policy restrictions in order to contain the spread of the SARS-CoV-2 virus. The aim of this study was to provide an overview of the available evidence on the cost-effectiveness of various COVID-19 policy measures.

METHODS:

A systematic literature search was conducted in PUBMED, EMBASE and WOS. Health economic evaluations considering both costs and outcomes were included. Their quality was comprehensively assessed using the CHEC tool. Next, the quality of the epidemiological models was evaluated.

RESULTS:

3688 papers were identified (March ‘21), of which 23 were included. The studies are very heterogeneous with regard to methodological quality, contextual factors, strategies’ content, adopted perspective, applied models and outcomes used. Overall, testing/screening, social distancing, personal protective equipment, quarantine/isolation and hygienic measures were cost-effective. Furthermore, the most optimal choice and combination of strategies depends on the reproduction number (R_e) and context. With a rising R_e, extending the testing strategy, and early implementation of combined multiple restriction measures is most efficient.

CONCLUSIONS:

The quality assessment highlighted numerous flaws and limitations in the study approaches, hence their results should be interpreted with caution as the specific context (country, target group, etc) is a key driver for cost-effectiveness. Finally, including a societal perspective in future evaluations is key, since this pandemic has an indirect impact on the onset and treatment of other conditions and on our global economy.