The CHOICE Institute, School of Pharmacy, University of Washington, Seattle, WA, USA.
Department of Economics, University of California, San Diego, CA, USA.
Value Health. 2021 May;24(5):632-640. doi: 10.1016/j.jval.2020.11.013. Epub 2021 Mar 8.
To estimate the overall quality-adjusted life-years (QALYs) gained by averting 1 coronavirus disease 2019 (COVID-19) infection over the duration of the pandemic.
A cohort-based probabilistic simulation model, informed by the latest epidemiological estimates on COVID-19 in the United States provided by the Centers for Disease Control and Prevention and literature review. Heterogeneity of parameter values across age group was accounted for. The main outcome studied was QALYs for the infected patient, patient's family members, and the contagion effect of the infected patient over the duration of the pandemic.
Averting a COVID-19 infection in a representative US resident will generate an additional 0.061 (0.016-0.129) QALYs (for the patient: 0.055, 95% confidence interval [CI] 0.014-0.115; for the patient's family members: 0.006, 95% CI 0.002-0.015). Accounting for the contagion effect of this infection, and assuming that an effective vaccine will be available in 3 months, the total QALYs gains from averting 1 single infection is 1.51 (95% CI 0.28-4.37) accrued to patients and their family members affected by the index infection and its sequelae. These results were robust to most parameter values and were most influenced by effective reproduction number, probability of death outside the hospital, the time-varying hazard rates of hospitalization, and death in critical care.
Our findings suggest that the health benefits of averting 1 COVID-19 infection in the United States are substantial. Efforts to curb infections must weigh the costs against these benefits.
估计在大流行期间避免 1 例新冠肺炎（COVID-19）感染所获得的总体质量调整生命年（QALYs）。
基于美国疾病控制与预防中心提供的最新 COVID-19 流行病学估计和文献回顾，采用基于队列的概率模拟模型。考虑了参数值在年龄组之间的异质性。研究的主要结果是感染患者、患者家属以及感染患者在大流行期间的传染效应的 QALYs。
避免代表性美国居民感染 COVID-19 将产生额外的 0.061（0.016-0.129）QALYs（患者：0.055，95%置信区间[CI] 0.014-0.115；患者家属：0.006，95%CI 0.002-0.015）。考虑到这种感染的传染效应，并假设 3 个月后将有有效的疫苗，避免 1 例单一感染所带来的总 QALYs 收益为 1.51（95%CI 0.28-4.37），惠及受指数感染及其后遗症影响的患者及其家属。这些结果对大多数参数值都是稳健的，最受有效繁殖数、医院外死亡率、住院和重症监护的时变危险率的影响。
我们的研究结果表明，避免美国 1 例 COVID-19 感染的健康益处是巨大的。遏制感染的努力必须权衡成本与这些益处。
