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

18 Pages Posted: 1 Jun 2021

See all articles by Yenny Fernanda Guzman Ruiz

Yenny Fernanda Guzman Ruiz

University of Washington

Andres I. Vecino-Ortiz

Johns Hopkins University

Nicolás Guzman-Tordecilla

Johns Hopkins University - Johns Hopkins Bloomberg School of Public Health

Enrique Peñaloza

Pontificia Universidad Javeriana

Julián Alfredo Fernández-Niño

Ministry of Health and Social Protection, Bogota - Department of Epidemiology and Demographics

Maylen Liseth Rojas-Botero

Ministry of Health and Social Protection, Bogota - Visual Analytics and Big Data

Fernando Ruiz Gomez

Ministry of Health and Social Protection, Bogota

Sean Sullivan

CHOICE Institute

Antonio J. Trujillo

Johns Hopkins University - Johns Hopkins Bloomberg School of Public Health

More...

Abstract

Background: The WHO recommends use of masks and social distancing to reduce transmission and death from COVID-19. Governments worldwide also rely on test-trace-isolate (TTI) programs for additional risk mitigation. This study aims to estimate the cost-effectiveness of implementing a national TTI strategy to reduce the number of severe and fatal cases of COVID-19 in Colombia. 

Methods: We developed a 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 a health system and a 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 lost, 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 reduced COVID-19 mortality by 67%. In addition, the program saved an average of $1,045 and $850 per case in the social and health system perspective, respectively. These savings are equivalent to almost four to ten times the annual Colombia per capita healthcare spending.

Interpretation: The TTI strategy in Colombia is a highly cost-effective public health intervention to reduce the burden of COVID-19. TTI is dependent on its capacity to identify and give early medical and social assistance to new cases. Our findings exemplify the success of using comprehensive strategies integrating telemedicine and predictive analysis to improve prevention programs.

Funding Information: This study was supported by the Colombian Ministry of Health through award number PUJ-04519-20 received by E.P. AVO and SDS declined to receive any funding support for this study.

Declaration of 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.

Ethics Approval Statement: This study was approved by the Institutional Review Board of the Johns Hopkins Bloomberg School of Public Health and deemed not human subjects research (IRB number: 14144).

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

Suggested Citation

Guzman Ruiz, Yenny Fernanda and Vecino-Ortiz, Andres I. and Guzman-Tordecilla, Deivis Nicolás and Peñaloza, Enrique and Fernández-Niño, Julián Alfredo and Rojas-Botero, Maylen Liseth and Ruiz Gomez, Fernando and Sullivan, Sean and Trujillo, Antonio J., Cost-Effectiveness of the COVID-19 Test, Trace and Isolate Program in Colombia. Available at SSRN: https://ssrn.com/abstract=3857609 or http://dx.doi.org/10.2139/ssrn.3857609

Yenny Fernanda Guzman Ruiz (Contact Author)

University of Washington

Seattle, WA 98195
United States

Andres I. Vecino-Ortiz

Johns Hopkins University

Baltimore, MD 20036-1984
United States

Deivis Nicolás Guzman-Tordecilla

Johns Hopkins University - Johns Hopkins Bloomberg School of Public Health ( email )

Enrique Peñaloza

Pontificia Universidad Javeriana

Julián Alfredo Fernández-Niño

Ministry of Health and Social Protection, Bogota - Department of Epidemiology and Demographics ( email )

Colombia

Maylen Liseth Rojas-Botero

Ministry of Health and Social Protection, Bogota - Visual Analytics and Big Data ( email )

Bogotá
Colombia

Fernando Ruiz Gomez

Ministry of Health and Social Protection, Bogota ( email )

Colombia

Sean Sullivan

CHOICE Institute ( email )

1959 Pacific St
NE Box 357631
Seattle, WA 98195
United States

Antonio J. Trujillo

Johns Hopkins University - Johns Hopkins Bloomberg School of Public Health ( email )

Wolfe Street
Baltimore, MD 21205
United States

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