Disease Burden Attributable to the First Wave of COVID-19 in China and the Effect of Timing on the Cost-Effectiveness of Movement Restriction Policies

May 1, 2021, 00:00
10.1016/j.jval.2020.12.009
https://www.valueinhealthjournal.com/article/S1098-3015(21)00033-4/fulltext
Title : Disease Burden Attributable to the First Wave of COVID-19 in China and the Effect of Timing on the Cost-Effectiveness of Movement Restriction Policies
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(21)00033-4&doi=10.1016/j.jval.2020.12.009
First page : 615
Section Title : THEMED SECTION: COVID-19
Open access? : No
Section Order : 615

Objectives

Movement restriction policies (MRPs) are effective in preventing/delaying COVID-19 transmission but are associated with high societal cost. This study aims to estimate the health burden of the first wave of COVID-19 in China and the cost-effectiveness of early versus late implementation of MRPs to inform preparation for future waves.

Methods

The SEIR (susceptible, exposed, infectious, and recovered) modeling framework was adapted to simulate the health and cost outcomes of initiating MRPs at different times: rapid implementation (January 23, the real-world scenario), delayed by 1 week, delayed by 2 weeks, and delayed by 4 weeks. The end point was set as the day when newly confirmed cases reached zero. Two costing perspectives were adopted: healthcare and societal. Input data were obtained from official statistics and published literature. The primary outcomes were disability-adjusted life-years, cost, and net monetary benefit. Costs were reported in both Chinese renminbi (RMB) and US dollars (USD) at 2019 values.

Results

The first wave of COVID-19 in China resulted in 38 348 disability adjusted life-years lost (95% CI 19 417-64 130) and 2639 billion RMB losses (95% CI 1347-4688). The rapid implementation strategy dominated all other delayed strategies. This conclusion was robust to all scenarios tested. At a willingness-to-pay threshold of 70 892 RMB (the national annual GDP per capita) per disability-adjusted life-year saved, the probability for the rapid implementation to be the optimal strategy was 96%.

Conclusions

Early implementation of MRPs in response to COVID-19 reduced both the health burden and societal cost and thus should be used for future waves of COVID-19.

Categories :
  • Budget Impact Analysis
  • Cost/Cost of Illness/Resource Use Studies
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Decision Modeling & Simulation
  • Economic Evaluation
  • Infectious Disease
  • Patient-Centered Research
  • Patient-reported Outcomes & Quality of Life Outcomes
  • Respiratory-Related Disorders
  • Specialized Treatment Areas
  • Specific Diseases & Conditions
  • Study Approaches
Tags :
  • cost-effectiveness analysis
  • COVID-19
  • DALY
  • disease burden
  • movement restriction policies
  • timing
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