Cost-Effectiveness of Public Health Measures to Control COVID-19 in China: A Microsimulation Modeling Study

The role of economic evaluation in modelling public health and social measures for pandemic policy: a systematic review

BACKGROUND

Dynamic transmission models are often used to provide epidemiological guidance for pandemic policy decisions. However, how economic evaluation is typically incorporated into this technique to generate cost-effectiveness estimates of pandemic policy responses has not previously been reviewed.

METHODS

We systematically searched the Embase, PubMed and Scopus databases for dynamic epidemiological modelling studies that incorporated economic evaluation of public health and social measures (PHSMs), with no date restrictions, on 7 July 2024.

RESULTS

Of the 2,719 screened studies, 51 met the inclusion criteria. Most studies (n = 42, 82%) modelled SARS-CoV-2. A range of PHSMs were examined, including school closures, testing/screening, social distancing and mask use. Half of the studies utilised an extension of a Susceptible-Exposed-Infectious-Recovered (SEIR) compartmental model. The most common type of economic evaluation was cost-effectiveness analysis (n = 24, 47%), followed by cost-utility analysis (n = 17, 33%) and cost-benefit analysis (n = 17, 33%).

CONCLUSIONS

Economic evaluation is infrequently incorporated into dynamic epidemiological modelling studies of PHSMs. The scope of this research should be expanded, given the substantial cost implications of pandemic PHSM policy responses.

Investigation on the possibility of dynamic COVID-Zero strategy in China: a population-based transmission model analysis and economic evaluation

OBJECTIVE

To explore the feasible and cost-effective intervention strategies to achieve the goal of dynamic COVID-Zero in China.

DESIGN

A Susceptible-Exposed-Infectious-Recovered model combined economic evaluation was used to generate the number of infections, the time for dynamic COVID-Zero and calculate cost-effectiveness under different intervention strategies. The model simulated the 1 year spread of COVID-19 in mainland China after 100 initial infections were imported.

INTERVENTIONS

According to close contact tracing degree from 80% to 100%, close contact tracing time from 2 days to 1 day, isolation time from 14 days to 7 days, scope of nucleic acid testing (NAT) from 10% to 100% and NAT frequency from weekly to every day, 720 scenarios were simulated.

OUTCOME MEASURE

Cumulative number of infections (CI), social COVID-Zero duration (SCD), total cost (TC) and incremental cost-effectiveness ratio.

RESULTS

205 of 720 scenarios could achieve the total COVID-Zero since the first case was reported. The fastest and most cost-effective strategy was Scenario 680, in which all close contacts were traced within 1 day, the isolation time was 14 days and 10% of the national population was randomly checked for NAT every day. In Scenario 680, the CI was 280 (100 initial infections) and the SCD was 13 days. The TC was ¥4126 hundred million and the cost of reducing one infection was ¥47 470. However, when the close contact tracing time was 2 days and the degree of close contact tracing was 80%-90%, the SCD would double to 24-101 days and the TCs increased by ¥16 505 to 37 134 hundred million compared with Scenario 680.

CONCLUSIONS

If all close contact was controlled within 1 day, the rapid social COVID-Zero can be achieved effectively and cost-effectively. Therefore, the future prevention and control of emerging respiratory infectious diseases can focus on enhancing the ability of close contact tracing.

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.

Effect of Nucleic Acid Screening Measures on COVID-19 Transmission in Cities of Different Scales and Assessment of Related Testing Resource Demands-Evidence from China

BACKGROUND

COVID-19 is in its epidemic period, and China is still facing the dual risks of import and domestic rebound. To better control the COVID-19 pandemic under the existing conditions, the focus of this study is to simulate the nucleic acid testing for different population size cities in China to influence the spread of COVID-19, assess the situation under different scenarios, the demand for the laboratory testing personnel, material resources, for the implementation of the nucleic acid screening measures, emergency supplies, and the configuration of human resources to provide decision-making basis.

METHODS

According to the transmission characteristics of COVID-19 and the current prevention and control strategies in China, four epidemic scenarios were assumed. Based on the constructed SVEAIiQHR model, the number of people infected with COVID-19 in cities with populations of 10 million, 5 million, and 500,000 was analyzed and predicted under the four scenarios, and the demand for laboratory testing resources was evaluated, respectively.

RESULTS

For large, medium, and small cities, whether full or regional nucleic acid screening can significantly reduce the epidemic prevention and control strategy of different scenarios laboratory testing resource demand difference is bigger, implement effective non-pharmaceutical interventions and regional nucleic acid screening measures to significantly reduce laboratory testing related resources demand, but will cause varying degrees of inspection staff shortages.

CONCLUSION

There is still an urgent need for laboratory testing manpower in China to implement effective nucleic acid screening measures in the event of an outbreak. Cities or regions with different population sizes and levels of medical resources should flexibly implement prevention and control measures according to specific conditions after the outbreak, assess laboratory testing and human resource need as soon as possible, and prepare and allocate materials and personnel.

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.

Research on Monetary Policy Implementation and Industrial Structure Transformation Under COVID-19—Evidence From Eight Economic Zones in Mainland China

The outbreak of COVID-19 has brought a serious impact on the economies of various countries, monetary policy needs to play a role in stimulating economic recovery when the economy encounters a serious negative impact. Since the recurrent outbreak of COVID-19 has caused great obstacles to the normal economic exchanges between countries, it has become particularly important to build the domestic market and optimize the industrial allocation at this time. This paper focuses on studying the dynamic impact of China's monetary policy implementation on the industrial structure during the pandemic. Based on the data of the eight major economic zones in Mainland China and the dataset containing many of China's macroeconomic variables, a SV-TVP-FAVAR model is established. The manuscript compares the time-varying effects of monetary policy tools on the industries at different stages before and after the epidemic. The study supported some interesting conclusions. (1) Either the quantitative or price-based monetary policy shocks have significant time-varying impacts on the industries in different economic zones. The impacts of monetary policy on the primary, secondary, and tertiary industries in each economic zone are uneven. (2) The developed Northern, Eastern, and Southern coastal economic zones in Mainland China are more sensitive to the changes in monetary policy. (3) COVID-19 has brought a tremendous negative shock on the economy, which has destroyed the original steady-state of the economic system and added more uncertainty to the regulatory effect of monetary policy. Compared with other periods in China's economic history that severely negatively impacted (the Southeast Asian financial crisis and the global economic crisis), industries in most economic zones under the COVID-19 epidemic have been affected by monetary policy for a longer lag time. Therefore, for the implementation of monetary policy, at the moment of COVID-19 epidemic, we should pay more attention to the dual-pillar role of macro-prudential regulation, further improve the process of China's interest rate reform, enrich the monetary toolbox, and implement differentiated monetary policies in line with the economic zone's position, to optimize the regional industrial structure, and promote long-term economic growth.

Comprehensive Analysis of the COVID-19: Based on the Social-Related Indexes From NUMBEO

Background

The COVID-19 has been spreading globally since 2019 and causes serious damage to the whole society. A macro perspective study to explore the changes of some social-related indexes of different countries is meaningful.

Methods

We collected nine social-related indexes and the score of COVID-safety-assessment. Data analysis is carried out using three time series models. In particular, a prediction-correction procedure was employed to explore the impact of the pandemic on the indexes of developed and developing countries.

Results

It shows that COVID-19 epidemic has an impact on the life of residents in various aspects, specifically in quality of life, purchasing power, and safety. Cluster analysis and bivariate statistical analysis further indicate that indexes affected by the pandemic in developed and developing countries are different.

Conclusion

This pandemic has altered the lives of residents in many ways. Our further research shows that the impacts of social-related indexes in developed and developing countries are different, which is bounded up with their epidemic severity and control measures. On the other hand, the climate is crucial for the control of COVID-19. Consequently, exploring the changes of social-related indexes is significative, and it is conducive to provide targeted governance strategies for various countries. Our article will contribute to countries with different levels of development pay more attention to social changes and take timely and effective measures to adjust social changes while trying to control this pandemic.