The cost-effectiveness of social distancing measures for mitigating the COVID-19 pandemic in a highly-populated country: A case study in Indonesia

Economic evaluation of strategies against coronavirus: a systematic review

BACKGROUND

The COVID-19 outbreak was defined as a pandemic on 11 March 2020 by the World Health Organization. After that, COVID-19 has enormously influenced health systems around the world, and it has claimed more than 4.2 million deaths until July 2021. The pandemic has led to global health, social and economic costs. This situation has prompted a crucial search for beneficial interventions and treatments, but little is known about their monetary value. This study is aimed at systematically reviewing the articles conducted on the economic evaluation of preventive, control and treatment strategies against COVID-19.

MATERIAL AND METHOD

We searched PubMed, Web of Science, Scopus, and Google Scholar from December 2019 to October 2021 to find applicable literature to the economic evaluation of strategies against COVID-19. Two researchers screened potentially eligible titles and abstracts. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to quality assessment of studies.

RESULTS

Thirty-six studies were included in this review, and the average CHEERS score was 72. Cost-effectiveness analysis was the most common type of economic evaluation, used in 21 studies. And the quality-adjusted life year (QALY) was the main outcome applied to measure the effectiveness of interventions, which was used in 19 studies. In addition, articles were reported a wide range of incremental cost-effectiveness ratio (ICER), and the lowest cost per QALY ($321.14) was related to the use of vaccines.

CONCLUSION

Based on the results of this systematic review, it seems that all strategies are likely to be more cost-effective against COVID-19 than no intervention and vaccination was the most cost-effective strategy. This research provides insight for decision makers in choosing optimal interventions against the next waves of the current pandemic and possible future pandemics.

Assessment of Post-Vaccination Immunologic Responses in Inactivated Virus COVID-19 Respondents

Introduction

The Indonesian Government's plan to contain the COVID-19 pandemic, aside from implementing health protocols, also involves vaccinating everyone with the inactivated SARS CoV2 vaccine until herd immunity is reached. The aim of this study was to assess the post-vaccination immune response to inactivated SARS CoV2 vaccine, namely Sinovac/Sinopharm, by measuring the antibodies (IgM and IgG) in subjects after their second dose of vaccination.

Materials and Methods

The design of the study was a cohort study using simple random sampling with 51 respondents aged 18-56 years who had received two doses of inactivated SARS-CoV-2 vaccine. All respondents were screened for SARS-CoV-2 infection prior to inclusion. Serum IgM and IgG antibodies were detected using a specific and sensitive automated chemiluminescent immunoassay (CLIA). CLIA uses the Cut Off Point (COI) value of >1 AU/ml for IgM and the Reactive Value of >10 AU/ml for IgG.

Results

This study showed that the IgM levels using a reactive Cut Off Point (COI) >1 were 18% in the first month, 14% in the third month, and 10% in the sixth month. There was a constant decline in the third comparison. Meanwhile, compared to the first month, 59% of respondents had IgG levels with reactive values over 10 AU/ml, which after decreasing by 35% in the third month, the number increased by 47% in the sixth month.

Conclusion

It has been evident that IgG and IgM antibody response could be induced by inactivated SARS-CoV-2 vaccine which can be influenced by age and detection time after the second dose of vaccination. Boosters, however, must be given after six months of the second dose, since antibody levels were seen to decrease after this period.

Cost-effectiveness of interventions for the prevention and control of COVID-19: Systematic review of 85 modelling studies

Background

We aimed to quantitatively summarise the health economic evaluation evidence of prevention and control programs addressing COVID-19 globally.

Methods

We did a systematic review and meta-analysis to assess the economic and health benefit of interventions for COVID-19. We searched PubMed, Embase, Web of Science, and Cochrane Library of economic evaluation from December 31, 2019, to March 22, 2022, to identify relevant literature. Meta-analyses were done using random-effects models to estimate pooled incremental net benefit (INB). Heterogeneity was assessed using I2 statistics and publication bias was assessed by Egger's test. This study is registered with PROSPERO, CRD42021267475.

Results

Of 16 860 studies identified, 85 articles were included in the systematic review, and 25 articles (10 studies about non-pharmacological interventions (NPIs), five studies about vaccinations and 10 studies about treatments) were included in the meta-analysis. The pooled INB of NPIs, vaccinations, and treatments were $1378.10 (95% CI = $1079.62, $1676.59), $254.80 (95% CI = $169.84, $339.77) and $4115.11 (95% CI = $1631.09, $6599.14), respectively. Sensitivity analyses showed similar findings.

Conclusions

NPIs, vaccinations, and treatments are all cost-effective in combating the COVID-19 pandemic. However, evidence was mostly from high-income and middle-income countries. Further studies from lower-income countries are needed.