Costing the COVID-19 Pandemic: An Exploratory Economic Evaluation of Hypothetical Suppression Policy in the United Kingdom

Zala, Darshan; Mosweu, Iris; Critchlow, Simone; Romeo, Renee; McCrone, Paul

OBJECTIVE: This study aims to cost and calculate the relative cost-effectiveness of the hypothetical suppression policies found in the Imperial College COVID-19 Response Team model. METHODS: Key population-level disease projections in deaths, intensive care unit bed days, and non–intensive care unit bed days were taken from the Imperial College COVID-19 Response Team report of March 2020, which influenced the decision to introduce suppression policies in the United Kingdom. National income loss estimates were from a study that estimated the impact of a hypothetical pandemic on the UK economy, with sensitivity analyses based on projections that are more recent. Individual quality-adjusted life-year (QALY) loss and costed resource use inputs were taken from published sources. RESULTS: Imperial model projected suppression polices compared to an unmitigated pandemic, even with the most pessimistic national income loss scenarios under suppression (10%), give incremental cost-effectiveness ratios below £50 000 per QALY. Assuming a maximum reduction in national income of 7.75%, incremental cost-effectiveness ratios for Imperial model projected suppression versus mitigation are below 60 000 per QALY. CONCLUSIONS: Results are uncertain and conditional on the accuracy of the Imperial model projections; they are also sensitive to estimates of national income loss. Nevertheless, it would be difficult to claim that the hypothetical Imperial model–projected suppression policies are obviously cost-ineffective relative to the alternatives available. Despite evolving differences between government policy and Imperial model–projected suppression policy, it is hoped this article will provide some early insight into the trade-offs that are involved.