Cost-Effectiveness of Interventions for the Prevention and Control of COVID-19: A Systematic Review and Meta-Analysis

Background: The COVID-19 pandemic is an unprecedented global crisis and has a profound impact on health-care systems, society and economy. The cost-effectiveness of different interventions for the prevention and control of COVID-19 remains debated. We aimed to quantitatively summarize 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 of COVID-19. We searched PubMed, Embase, Web of Science and Cochrane Library of economic evaluation from 31 December, 2019 to 13 July, 2021 to identify relevant literatures. Two researchers screened titles and abstracts, extracted data from full-text articles, and did quality assessment by the Consolidated Health Economic Evaluation Reporting Standards checklist. Meta-analyses were done using random-effects models to estimate pooled incremental net benefit (INB). Heterogeneity was assessed using I^2 statistics, and publication bias was assessed by Egger’s test. This study is registered with PROSPERO, CRD42021267475.Findings Of 15542 studies identified, 50 articles were included in the systematic review, and 17 articles (9 studies about non-pharmacological interventions (NPIs), 4 studies about vaccinations and 4 studies about treatments) were included in the meta-analysis. The pooled INB of NPIs, vaccinations and treatments were $972·05 (95% CI $772·52 to $1171·59), $295·18 (95% CI $209·58 to $380·77) and $14854·90 (95% CI $1783·60 to $27926·20), respectively. The pooled INBs in subgroups of screening, and suppression were $2390·89 (95% CI $1932·92 to $2848·85) and $2156·00 (95% CI $1114·40 to $3197·59). Sensitivity analyses showed similar findings. Interpretation: NPIs, vaccinations and treatments are all cost-effective in combating COVID-19 pandemic. However, evidence almost from high-income and middle-income countries, further studies from lower-income countries are needed. Funding: National Natural Science Foundation of China (No. 71910107004, 91746205, 72122001, 71934002). Declaration of Interest: The authors declare no competing interests.