The Effect of COVID-19 on QALY and DALY Measurements

Abstract

Objective: The COVID-19 epidemic in the world has affected many systems, especially health systems. Increasing demand in health expenditures has also led to an increase in costs. Therefore, the evaluation of the cost per quality-adjusted life years (QALY) and disabilityadjusted life years (DALY) as health criteria will support the decision processes of health managers. The purpose of this systematic review, QALY and DALY parameters is to evaluate the effects of COVID-19. Material and Method: In this systematic review, the declaration of the PRISMA has been used as guidance. Three electronic databases were used in the research strategy: Scopus, Web of Science, and PUBMED. Databases scanned between 01/01/2020 and 31/12/2022. In the scanning, “COVID-19” and “QALY” and “COVID-19” and “DALY” keywords were used. Results: The number of studies accessed from databases is 352. The number of studies examined in detail is 290. Thirty-seven studies were included in the review. Different QALY and DALY criteria have been reached in research based on actual and estimated data. It has been determined that the health gains obtained by applying vaccines, drugs, and PCR tests have also changed. Conclusion: It has been determined that QALY and DALY health outcomes vary according to the resources they allocate to health and the characteristics of health systems during the COVID-19 pandemic.

Keywords

• COVID-19
• health care economics and organizations
• quality adjusted life years
• disability adjusted life years.

COVID-19’un QALY ve DALY Ölçütlerine Etkisi

Abstract

Amaç: Dünya’da COVID-19 salgını özellikle sağlık sistemleri olmak üzere birçok sistemi etkilemiştir. Sağlık harcamalarında artan talep maliyetlerin de artışına neden olmuştur. Dolayısıyla sağlık ölçütleri olarak kaliteye göre ayarlanmış yaşam yılları (Quality-Adjusted Life-Year; QALY) ve engelliliğe göre ayarlanmış yaşam yılları (Disability-Adjusted Life Year; DALY) başına düşen maliyetlerin değerlendirilmesi sağlık yöneticilerinin karar süreçlerini destekleyecektir. Bu sistematik derlemenin amacı, COVID-19’un QALY ve DALY ölçütlerine etkisini değerlendirmektir. Gereç ve Yöntem: Sistematik derlemede PRISMA bildirgesi rehber alınmıştır. Araştırma stratejisinde üç elektronik veri tabanı kullanılmıştır: Scopus, Web of Science, PUBMED. Veri tabanları 01/01/2020-31/12/2022 tarihleri arasında taranmıştır. Taramalarda “COVID-19” and “QALY” ile “COVID-19” and “DALY” anahtar kelimeleri kullanılmıştır. Bulgular: Veri tabanlarından ulaşılan araştırma sayısı 352’dir. Ayrıntılı incelenen araştırma sayısı 290’dır. Derlemeye 37 çalışma dahil edilmiştir. Gerçekleşen ve tahmini verilere dayalı araştırmalarda farklı QALY ve DALY ölçütlerine ulaşılmıştır. Aşı, ilaç ve PCR testlerinin uygulanması ile elde edilen sağlık kazanımları da değişmiştir. Sonuç: COVID-19 pandemi döneminde QALY ve DALY sağlık çıktılarının ülkelerin sağlığa ayırdıkları kaynaklar ve sağlık sistemlerinin özelliklerine göre değişkenlik gösterdiği belirlenmiştir.

Keywords

• COVID-19
• sağlık hizmeti ekonomisi ve organizasyonlar
• kaliteye göre ayarlanmış yaşam yılları
• engelliliğe göre ayarlanmış yaşam yılları.

References

1. World Health Organization. Health and care worker deaths during COVID-19. News. [homepage on the Internet]. Available from https:// www.who.int/news/item/20-10-2021-health-and-care-worker-deathsduring-covid-19
2. Domínguez-Salas S, Gómez-Salgado J, Guillén-Gestoso C, Romero- Martín M, Ortega-Moreno M, Ruiz-Frutos C. Health care workers' protection and psychological safety during the COVID-19 pandemic in Spain. J Nurs Manag. 2021; 29(7): 1924– 33.
3. Wnuk A, Oleksy T, Maison D. The acceptance of COVID-19 tracking technologies: The role of perceived threat, lack of control, and ideological beliefs. PLoS One. 2020; 15: e0238973.
4. Verguet S, Hailu A, Eregata GT. COVID-19 sonrası dönemde evrensel sağlık sigortasına doğru. Nat Med. 2021; 27: 380–87.
5. Chattopadhyay SK, Jacob V, Hopkins DP, Lansky A, Elder R, Cuellar AE et al. Community guide methods for systematic reviews of economic evidence. Am J Prev Med. 2023; 64(4): 569-78.
6. Neumann PJ, Anderson JE, Panzer AD, Pope EF, D'Cruz BN, Kim DD. Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures. Gates Open Res. 2018; 5:2-5.
7. Mendoza RL. Beyond QALYs and DALYs: factoring in the well-being effects of dietary supplementation with omega-3 fatty acids in dry eye syndrome. IJPHM. 2022; 16(4): 513-41.
8. Tejada RA, Malagón T, Franco EL. Cost-effectiveness of human papillomavirus vaccination in girls living in Latin American countries: A systematic review and meta-analysis. Vaccine. 2022; 40(19):2667-78.

9. Liberati A, Altman DG, Tetzlaff J et al. The PRISMA statement for reporting reviews and meta analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 151(4):65–9.
10. Gökdemir F, Dolgun G. Writing material & method section in qualitative, quantitative, systematic review, meta-analysis and meta-synthesis studies. Arc Health Sci Res. 2020; 7(2): 189-95.
11. Singh BB, Devleesschauwer B, Khatkar MS. Disability-adjusted life years (DALYs) due to the direct health impact of COVID-19 in India. Sci Rep. 2020; 12: 24-54.
12. McDonald SA, Lagerweij GR, de Boer, P. The estimated disease burden of acute COVID-19 in the Netherlands in 2020, in disability-adjusted lifeyears. Eur J Epidemiol. 2022; 37: 1035–47.
13. Cuschieri S, Calleja N, Devleesschauwer B. Estimating the direct Covid-19 disability-adjusted life years impact on the Malta population for the first full year. BMC Public Health. 2021; 21: 1827.
14. Vasishtha G, Mohanty SK, Mishra U.S. Impact of COVID-19 infection on life expectancy, premature mortality and DALY in Maharashtra, India. BMC Infect Dis. 2021: 21- 34.
15. Vaezi A, Meysamie A. COVID-19 vaccines cost-effectiveness analysis: a scenario for Iran. Vaccines. 2022; 10(1):37.
16. Asdaq SMB, Rabbani SI, Alshammari MK, Alshammari RS, Kamal M, Imran M et al. Burden of COVID-19: a preliminary analysis in the population of Saudi Arabia. Peer J. 2022; 13219:1-16.
17. Coute RA, Nathanson BH, Kurz MC, Mader TJ. Estimating the impact of the COVID-19 pandemic on out-of-hospital cardiac arrest burden of disease in the United States. JACEP Open. 2022; 3: e12811.
18. Wyper GMA, Fletcher E, Grant I, McCartney G, Fischbacher C, Harding O et al. Measuring disability-adjusted life years (DALYs) due to COVID-19 in Scotland. Arch Public Health. 2022; 80(1):105.
19. Fekadu G, Jiang X, Yao J, You JHS. Cost-effectiveness of video-observed therapy for ambulatory management of active tuberculosis during the COVID-19 pandemic in a high-income country. Int J Infect Dis. 2021; 113:271-78.
20. Mayin KB, Munteh PA, Fon Wilfred M. Costs and benefits of early response in the Covid-19 outbreak in Cameroon: DALYs, treatment cost and labour supply lost. AJOL. 2020; 16: 43-51.
21. Klazura G, Kisa P, Wesonga A, Nabukenya M, Kakembo N, Nimanya S et al. Pediatric surgery backlog at a Ugandan tertiary care facility: COVID-19 makes a chronic problem acutely worse. Pediatr Surg Int. 2022; 38:1391-7.
22. Mohanty SK, Dubey M, Udaya SM, Sahoo U. Impact of COVID-19 attributable deaths on longevity, premature mortality and DALY: estimates of USA, Italy, Sweden and Germany. medRxiv. 2020; 1-22.
23. Nurchis MC, Pascucci D, Sapienza M, Villani L, D’Ambrosio F, Castrini F et al. Impact of the burden of COVID-19 in Italy: results of disability-adjusted life years (DALYs) and productivity loss. Int. J. Environ. Res. Public Health. 2020; 17(12):4233.
24. Pires SM, Redondo HG, Espenhain L. Disability adjusted life years associated with COVID-19 in Denmark in the first year of the pandemic. BMC Public Health. 2022; 13-5.
25. Damerow S, Rommel A, Beyer AK, Hapke U, Schienkiewitz A, Starker A et al. Health situation in Germany during the COVID-19 pandemic developments over time for selected indicators of GEDA 2019/2020- an update. J Health Monit. 2022; 2-19.
26. Angeles MR, Wanni Arachchige Dona S, Nguyen H. Modelling the potential acute and post-acute burden of COVID-19 under the Australian border re-opening plan. BMC Public Health. 2022; 22: 757.
27. Gianino MM, Savatteri AG, Politano MC, Nurchis D, Pascucci G. Burden of COVID-19: disability-adjusted life years (DALYs) across 16 European countries. Eur Rev Med Pharmacol Sci. 2021; 25(17): 5529-41.
28. Whittington MD, Pearson SD, Rind DM, Campbell JD. The Costeffectiveness of remdesivir for hospitalized patients with COVID-19. Value Health. 2022; 25(5):744-50.
29. Jiang Y, Cai D, Chen D, Jiang S, Si L, Wu J. Economic evaluation of remdesivir for the treatment of severe COVID-19 patients in China under different scenarios. Br J Clin Pharmacol. 2021; 87(11):4386-96.
30. Oksuz E, Malhan S, Gonen MS, Kutlubay Z, Keskindemirci Y, Jarrett J et al. Cost-effectiveness analysis of remdesivir treatment in COVID-19 patients requiring low-flow oxygen therapy: payer perspective in Turkey. Adv Ther. 2021; 38(9):4935-48.
31. Congly SE, Varughese RA, Brown CE, Clement FM, Saxinger L. Treatment of moderate to severe respiratory COVID-19: a cost-utility analysis. Sci Rep. 2021; 11(1):17787.
32. Fernandes RRA, Santos MDS, Magliano CADS, Tura BR, Macedo LSDN, Padila MP et al. Cost utility of vaccination against COVID-19 in Brazil. Value Health Reg Issues. 2022; 31:18-24.
33. Orlewska K, Wierzba W, Śliwczynski A. Cost-effectiveness analysis of COVID-19 vaccination in Poland. Arch Med Sci. 2021; 18(4):1021-30.
34. Hagens A, İnkaya AÇ, Yildirak K, Sancar M, van der Schans J, Acar Sancar A. COVID-19 vaccination scenarios: a cost-effectiveness analysis for Turkey. Vaccines. 2021; 9(4):399.
35. Kohli M, Maschio M, Becker D, Weinstein MC. The potential public health and economic value of a hypothetical COVID-19 vaccine in the United States: use of cost-effectiveness modeling to inform vaccination prioritization. Vaccine. 2021; 39(7):1157-64.
36. Jiang X, Yao J, You JH. Cost-effectiveness of a Telemonitoring program for patients with heart failure during the COVID-19 pandemic in Hong Kong: model development and data analysis. J Med Internet Res. 2021; 23(3): e26516.
37. Padula WV, Miano MA, Kelley MA, Crawford SA, Choy BH, Hughes RM et al. A cost-utility analysis of remote pulse-oximetry monitoring of patients with COVID-19. Value in Health. 2022; 25(6): 890-96.
38. Henderson C, Knapp M, Fernández JL, Beecham J, Hirani SP, Cartwright M et al. Cost effectiveness of telehealth for patients with long term conditions (whole systems demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial. BMJ. 2013; 20: 346: f1035.
39. Losina E, Leifer V, Millham L, Panella C, Hyle EP, Mohareb AM et al. College campuses and COVID-19 mitigation: clinical and economic value. Ann Intern Med. 2021; 174(4):472-83.
40. Vilches TN, Rafferty E, Wells CR. Economic evaluation of COVID-19 rapid antigen screening programs in the workplace. BMC Med. 2022; 20: 452.
41. Mahony JF. Revision of Ireland’s cost-effectiveness threshold: new state-industry drug pricing deal should adequately reflect opportunity costs. PharmacoEconomics-Open. 2021; 5: 339–48.
42. Zala D, Mosweu I, Critchlow S, Romeo R, McCrone P. Costing the COVID-19 pandemic: an exploratory economic evaluation of hypothetical suppression policy in the United Kingdom. Value Health. 2020; 23(11):1432-37.
43. Martin C, Luteijn M, Letton W, Robertson J, McDonald S. A model framework for projecting the prevalence and impact of long-COVID in the UK. PLoS One. 2021; 16(12): e0260843.
44. Fink G, Tediosi F, Felder S. Burden of Covid-19 restrictions: national, regional and global estimates. eClinicalMedicine. 2022; 45:101305.
45. Robinson LA, Eber MR, Hammitt JK. Valuing COVID-19 morbidity risk reductions. J Benefit Cost Anal. 2022;13(2):247-68.
46. Wouterse B, Ram F, van Baal P. Quality-adjusted life-years lost due to COVID-19 mortality: methods and application for the Netherlands. Value in Health. 2022; 25(5): 731-35.
47. Maya S, McCorvie R, Jacobson K, Shete PB, Bardach N, Kahn JG. COVID-19 testing strategies for K-12 schools in California: a costeffectiveness analysis. Int. J. Environ. Res. Public Health. 2022; 19(15):9371.
48. Moran DP, Pires SM, Wyper GMA, Devleesschauwer B, Cuschieri S, Kabir Z. Estimating the direct disability-adjusted life years associated with COVID-19 in the Republic of Ireland: the first full year. Int J Public Health. 2022; 67:1604699.