A Cost-Benefit Analysis of the COVID-19 Asymptomatic Mass Testing Strategy in the North Metropolitan Area of Barcelona

Abstract

Background: The epidemiological situation generated by COVID-19 has highlighted the importance of applying non-pharmacological measures in the management of the epidemic. Mass screening of the asymptomatic general population has been established as a priority strategy by carrying out diagnostic tests to detect possible cases, isolate contacts, cut transmission chains and thus limit the spread of the virus. Objective: To evaluate the economic impact of mass COVID-19 screenings of an asymptomatic population during the first and second wave of the epidemic in Catalonia, Spain. Methodology: Cost-Benefit Analysis based on the estimated total costs of mass screening versus health gains and associated health costs avoided. Results: Excluding the value of monetized health, the Benefit-Cost ratio was estimated at 0.45, a low value that would seem to advise against mass screening policies. However, if monetized health is included, the ratio is close to 1.20, reversing the interpretation. In other words, the monetization of health is the critical element that tips the scales in favour of the desirability of screening. Results show that the interventions with the highest return are those that maximize the percentage of positives detected. Conclusion: Efficient management of resources for the policy of mass screening in asymptomatic populations can generate high social returns. The positivity rate critically determines its desirability. Likewise, precocity in the detection of cases will cut more transmissions in the chain of contagion and increase the economic return of these interventions. Maximizing the value of resources depends on screening strategies being accompanied by contact-tracing and specific in their focus, targeting, for example, high-risk subpopulations with the highest rate of expected positives.

Development of a risk assessment profile tool to determine appropriate use of SARS-CoV-2 rapid antigen detection tests for different activities and events in Ireland, since October 2021

“…Testing strategies for SARS-CoV-2 vary widely between countries [ 12 ]. One strategy for using Ag-RDT is to have proactive localised screening to detect the highest number of asymptomatic infectious cases at the lowest cost [ 13 ]. This risk assessment profile tool facilitates a focused approach based on assessments of risk derived from current national epidemiology and international published research.…”

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

“…Therefore, mass testing is one of the most effective interventions to control the epidemic. There are also studies that show that large-scale nucleic acid testing will indeed save a lot of laboratory resources and human resources compared to full-staff nucleic acid testing [ 50 ]; secondly, by carrying out large-scale nucleic acid testing supplemented by some prevention and control measures, it is indeed possible to avoid the cost of closing the city.…”

A Cost-Benefit Analysis of COVID-19 Vaccination in Catalonia

“…According to this approach, the savings generated by vaccination will be equal to the product of the effectiveness of the vaccine against cases, hospitalizations, ICUs and deaths, respectively, by the proportion of fully-vaccinated individuals, for the incidence reported in the pre-vaccination period in each age group. Using parameters from previous literature, it is assumed that 1% of cases suffer from some type of sequelae [15].…”

“…In the case of laboratory tests (PCR and RAT), the cost reimbursed by the healthcare contractor during COVID are used. Health gains were measured in Quality-Adjusted Life Years (QALYs) associated with deaths and cases of long-term morbidity avoided and monetized according to previous studies [15].…”