A systematic review of the costs relating to non-pharmaceutical interventions against infectious disease outbreaks
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Non-pharmaceutical interventions (NPIs) are the cornerstone of infectious disease outbreak response in the absence of effective pharmaceutical interventions. Outbreak strategies often involve combinations of NPIs that may change according to disease prevalence and population response. Little is known about how costly each NPI is to implement. This information is essential to inform policy decisions for outbreak response.
Objective
To address this gap in existing literature, we conducted a systematic review on outbreak costing and simulation studies related to a number of NPI strategies, including isolating infected individuals, contact tracing and quarantine, and school closures.
Methods
Our search covered the MEDLINE and EMBASE databases, studies published between 1990 and 24 March 2020 were included. We included studies containing cost data for our NPIs of interest in pandemic, epidemic, and outbreak response scenarios.
Results
We identified 61 relevant studies. There was substantial heterogeneity in the cost components recorded for NPIs in outbreak costing studies. The direct costs of NPIs for which costing studies existed therefore also ranged widely: isolating infected individuals per case: 141.18-1042.68 USD 2020, tracing and quarantine of contacts per contact: 40.73-93.59 USD 2020 , social distancing: 33.76-167.92 USD 2020, personal protection and hygiene: 0.15-895.60 USD 2020.
Conclusion
While there are gaps and heterogeneity in available cost data, the findings of this review and the collated cost database serve as an important resource for evidence-based decision-making for estimating costs pertaining to NPI implementation in future outbreak response policies.
Non-pharmaceutical interventions (NPIs) are the cornerstone of infectious disease outbreak response in the absence of effective pharmaceutical interventions. Outbreak strategies often involve combinations of NPIs that may change according to disease prevalence and population response. Little is known about how costly each NPI is to implement. This information is essential to inform policy decisions for outbreak response.
Objective
To address this gap in existing literature, we conducted a systematic review on outbreak costing and simulation studies related to a number of NPI strategies, including isolating infected individuals, contact tracing and quarantine, and school closures.
Methods
Our search covered the MEDLINE and EMBASE databases, studies published between 1990 and 24 March 2020 were included. We included studies containing cost data for our NPIs of interest in pandemic, epidemic, and outbreak response scenarios.
Results
We identified 61 relevant studies. There was substantial heterogeneity in the cost components recorded for NPIs in outbreak costing studies. The direct costs of NPIs for which costing studies existed therefore also ranged widely: isolating infected individuals per case: 141.18-1042.68 USD 2020, tracing and quarantine of contacts per contact: 40.73-93.59 USD 2020 , social distancing: 33.76-167.92 USD 2020, personal protection and hygiene: 0.15-895.60 USD 2020.
Conclusion
While there are gaps and heterogeneity in available cost data, the findings of this review and the collated cost database serve as an important resource for evidence-based decision-making for estimating costs pertaining to NPI implementation in future outbreak response policies.
Date Issued
2021-09-01
Date Acceptance
2021-04-23
Citation
Applied Health Economics and Health Policy, 2021, 19, pp.673-697
ISSN
1175-5652
Publisher
Springer
Start Page
673
End Page
697
Journal / Book Title
Applied Health Economics and Health Policy
Volume
19
Copyright Statement
© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Sponsor
Wellcome Trust
Medical Research Council (MRC)
National Institute for Health Research
Abdul Latif Jameel Foundation
Imperial College LOndon
Identifier
https://link.springer.com/article/10.1007%2Fs40258-021-00659-z
Grant Number
215163/Z/18/Z
MR/R015600/1
NIHR200908
Subjects
Social Sciences
Science & Technology
Life Sciences & Biomedicine
Economics
Health Care Sciences & Services
Health Policy & Services
Business & Economics
HEALTH-CARE WORKERS
SCHOOL CLOSURE
PANDEMIC INFLUENZA
ECONOMIC-IMPACT
MEASLES OUTBREAK
MITIGATION STRATEGIES
MACROECONOMIC IMPACT
EPIDEMIC
QUARANTINE
POLICIES
Health Policy & Services
1117 Public Health and Health Services
1402 Applied Economics
1505 Marketing
Publication Status
Published
Date Publish Online
2021-06-11