Objective: Interventions to reduce the spread of Covid-19 have both high economic cost and the potential to save millions of Quality Adjusted Life Years (QALYs). Understanding the relative costs and benefits of different policies will lead to improved policy making. The purpose of this presentation is to calculate the Incremental Cost Effectiveness Ratio (ICER) for three major Covid-19 policies: non-medical interventions (NMI), vaccine development and therapeutic innovations in the hospital care (“Innovations”).

Methods: A Susceptible-Infected-Recovered model was developed to predict total Covid-19 related QALY losses in the presence or absence of different policies. Key QALY effects were reductions in Covid-19 related deaths and increases in preventable non-Covid-19 deaths due to health system closures. Key costs included reductions in GDP, reduced lifetime earnings from school closures and health system spending. An ICER was calculated for each policy option and combination of policy options versus a baseline of “do nothing” and Innovation only.

Results: NMIs reduce the rate of transmission, innovations reduce the mortality rate and vaccines reduce the susceptible population. Innovations had the lowest cost per QALY gained vs “do nothing” with a cost of $2,089 per QALY gained. Vaccines cost $34,777 per QALY gained in isolation, while NMIs alone were dominated by other options. Innovations alone dominated most alternatives, except for the combination of Innovations and Vaccines ($58,528 per QALY gained) and Innovations, Vaccines and NMIs ($6.2m per QALY gained).

Conclusions: Of the three approaches to Covid-19, Innovations was the most cost effective and was well justified under any standard cost effectiveness threshold. The cost per QALY gained for vaccine development, either alone or in concert with other approaches, is well within the standard for cost effectiveness. NMIs reduced deaths and saved QALYs, but the cost per QALY gained is well outside the usual accepted limits.