Cost-Effectiveness of the COVID-19 Test, Trace and Isolate Program in Colombia.

Publisher: Elsevier Ltd Country of Publication: England NLM ID: 9918232503006676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2667-193X (Electronic) Linking ISSN: 2667193X NLM ISO Abbreviation: Lancet Reg Health Am Subsets: PubMed not MEDLINE

Original Publication: [Oxford] : Elsevier Ltd., [2021]-

Background: During the COVID-19 pandemic, Test-Trace-Isolate (TTI) programs have been recommended as a risk mitigation strategy. However, many governments have hesitated to implement them due to their costs. This study aims to estimate the cost-effectiveness of implementing a national TTI program to reduce the number of severe and fatal cases of COVID-19 in Colombia.
Methods: We developed a Markov simulation model of COVID-19 infection combined with a Susceptible-Infected-Recovered structure. We estimated the incremental cost-effectiveness of a comprehensive TTI strategy compared to no intervention over a one-year horizon, from both the health system and the societal perspective. Hospitalization and mortality rates were retrieved from Colombian surveillance data. We included program costs of TTI intervention, health services utilization, PCR diagnosis test, productivity loss, and government social program costs. We used the number of deaths and quality-adjusted life years (QALYs) as health outcomes. Sensitivity analyses were performed.
Findings: Compared with no intervention, the TTI strategy reduces COVID-19 mortality by 67%. In addition, the program saves an average of $1,045 and $850 per case when observed from the social and the health system perspective, respectively. These savings are equivalent to two times the current health expenditures in Colombia per year.
Interpretation: The TTI program is a highly cost-effective public health intervention to reduce the burden of COVID-19 in Colombia. TTI programs depend on their successful and speedy implementation.
Funding: This study was supported by the Colombian Ministry of Health through award number PUJ-04519-20 received by EPQ AVO and SDS declined to receive any funding support for this study. The contents are the responsibility of all the individual authors.
Competing Interests: Three of the authors (JFN, MRB, and FR) are direct employees of the funding institution (Colombian Ministry of Health). The other authors do not present any conflict of interest.
(© 2021 The Author(s).)

Curr Hypertens Rep. 2020 Jun 6;22(6):42. (PMID: 32506273)
J Thorac Dis. 2020 Mar;12(3):165-174. (PMID: 32274081)
Clin Microbiol Infect. 2021 Jan;27(1):105-111. (PMID: 32971254)
Clin Microbiol Infect. 2021 Jan;27(1):112-117. (PMID: 33007478)
PLoS One. 2021 Mar 4;16(3):e0246987. (PMID: 33661926)
Rev Salud Publica (Bogota). 2014 Sep-Oct;16(5):673-82. (PMID: 26120753)
Lancet Microbe. 2021 Jan;2(1):e13-e22. (PMID: 33521734)
J Med Internet Res. 2015 Jul 21;17(7):e178. (PMID: 26199142)
BMJ. 2020 May 13;369:m1859. (PMID: 32404304)
Eur J Epidemiol. 2020 Aug;35(8):743-748. (PMID: 32656618)
Trop Med Infect Dis. 2021 Jan 27;6(1):. (PMID: 33513668)
Biomedica. 2020 Oct 30;40(Supl. 2):77-79. (PMID: 33152191)
Pharmacoeconomics. 2009;27(11):903-17. (PMID: 19888791)
Value Health Reg Issues. 2021 Dec;26:24-32. (PMID: 33773292)
Acad Emerg Med. 2020 Aug;27(8):681-692. (PMID: 32779828)
Rev Salud Publica (Bogota). 2023 Feb 6;22(2):123-131. (PMID: 36753100)
Vaccine. 2021 Feb 12;39(7):1157-1164. (PMID: 33483216)
Arch Clin Biomed Res. 2023;7(1):58-63. (PMID: 37009074)
Chaos Solitons Fractals. 2020 Oct;139:110057. (PMID: 32834610)
Expert Rev Respir Med. 2021 Apr;15(4):543-552. (PMID: 33249945)
PLoS One. 2020 Nov 3;15(11):e0241536. (PMID: 33141862)
J Med Econ. 2021 Jan-Dec;24(1):1060-1069. (PMID: 34357843)
Nat Commun. 2021 Jan 15;12(1):378. (PMID: 33452267)

Keywords: COVID-19; Cost-effectiveness analysis; Test-Trace-Isolate (TTI); risk assessment and mitigation

Date Created: 20211110 Latest Revision: 20231106

20240105

PMC8560002

10.1016/j.lana.2021.100109

34755146