Tackling covid-19: are the costs worth the benefits?
John Appleby
Abstract
It is hard to write about the economics of covid-19 while we are grappling with such an unprecedented global emergency.But questions are being voiced-from presidents and commentators to health economists 1-3 and the German Council of Economic Experts 4 -about the cost effectiveness of the measures being used to tackle the disease.In short: are the costs worth the benefits?This may seem an outrageous question.Surely, we must do all we can to minimise mortality and morbidity from covid-19?But the cost-benefit question is one that all health systems face every day-is drug X better than drug Y (or doing nothing)?Should stroke services be centralised?How long should treatment continue for a particular patient?Or more specifically, which patients with covid-19 should be prioritised for ventilation? 5though there is no simple fix to many of these wicked choices, the National Institute for Health and Care Excellence (NICE) was set up in the UK in an attempt to make what were previously somewhat opaque decisions more transparent and more consistent.The weighing up of costs and effects to be judged against a threshold value of the effects (benefits) is at the heart of NICE's decision making.