Table 2.
Model-projected life-years lost, health-care costs, and cost-effectiveness of COVID-19 intervention strategies in KwaZulu-Natal province, South Africa
| Total life-years lost,*n | Health-care costs over 360-day period, US$† | ICER, US$ per YLS‡ | |
|---|---|---|---|
| Re 1·5 | |||
| Health-care testing alone | 450 940 | 437 000 000 | .. |
| Health-care testing, contact tracing, isolation centres, mass symptom screening, and quarantine centres | 27 220 | 581 000 000 | 340 |
| Health-care testing and contact tracing | 322 970 | 588 000 000 | Dominated |
| Health-care testing, contact tracing, isolation centres, and mass symptom screening | 60 930 | 668 000 000 | Dominated |
| Health-care testing, contact tracing, and isolation centres | 128 890 | 780 000 000 | Dominated |
| Health-care testing, contact tracing, isolation centres, and quarantine centres | 60 190 | 965 000 000 | Dominated |
| Re 1·2 | |||
| Health-care testing, contact tracing, isolation centres, and quarantine centres | 3890 | 139 000 000 | .. |
| Health-care testing, contact tracing, and isolation centres | 6850 | 141 000 000 | Dominated |
| Health-care testing, contact tracing, isolation centres, and mass symptom screening | 4260 | 183 000 000 | Dominated |
| Health-care testing, contact tracing, isolation centres, mass symptom screening, and quarantine centres | 2040 | 190 000 000 | 27 590 |
| Health-care testing and contact tracing | 32 040 | 276 000 000 | Dominated |
| Health-care testing alone | 97 600 | 393 000 000 | Dominated |
Strategies are listed in order of ascending costs. Life-years and costs were rounded, but the ICER was calculated using non-rounded values for life-years and costs. ICER=incremental cost-effectiveness ratio. YLS=years of life saved. Re=effective reproductive number. Dominated=strong dominance, resulting in more life-years lost and higher costs than an alternative strategy.
We assumed that each death results in 16·8 life-years lost, on average, based on our derivation (appendix pp 5–6).
This reflects costs to the health-care sector.
The ICER is the difference between two strategies in costs divided by the difference in undiscounted life-years (16·8 YLS per averted COVID-19 death; appendix pp 5–6); a strategy was considered cost-effective when the ICER was less than US$3250 per YLS.10