Modelling the cost-effectiveness of essential and advanced critical care for Covid-19 patients in Kenya

Bibliographic Data

ID21880435
AuthorsAngela Kairu (0000-0002-0965-4460, Kenya Medical Research Institute, corresponding author), Vincent Were (0000-0002-3554-795X, Kenya Medical Research Institute), Lynda Isaaka (0000-0003-1589-4134, Kenya Medical Research Institute), Ambrose Agweyu (0000-0001-8760-1279, Kenya Medical Research Institute), Samuel Aketch (Kenya Medical Research Institute), Edwine Barasa (0000-0001-5793-7177, Kenya Medical Research Institute)
Year2021
Volume6
Issue12
Pagese007168
Publication date2021-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2021-007168
PMID34876459
OpenAlexW4225771393
LanguageEN
Citations received6
References cited24

BACKGROUND: Case management of symptomatic COVID-19 patients is a key health system intervention. The Kenyan government embarked to fill capacity gaps in essential and advanced critical care (ACC) needed for the management of severe and critical COVID-19. However, given scarce resources, gaps in both essential and ACC persist. This study assessed the cost-effectiveness of investments in essential and ACC to inform the prioritisation of investment decisions. METHODS: We employed a decision tree model to assess the incremental cost-effectiveness of investment in essential care (EC) and investment in both essential and ACC (EC +ACC) compared with current healthcare provision capacity (status quo) for COVID-19 patients in Kenya. We used a health system perspective, and an inpatient care episode time horizon. Cost data were obtained from primary empirical analysis while outcomes data were obtained from epidemiological model estimates. We used univariate and probabilistic sensitivity analysis to assess the robustness of the results. RESULTS: The status quo option is more costly and less effective compared with investment in EC and is thus dominated by the later. The incremental cost-effectiveness ratio of investment in essential and ACC (EC+ACC) was US$1378.21 per disability-adjusted life-year averted and hence not a cost-effective strategy when compared with Kenya's cost-effectiveness threshold (US$908). CONCLUSION: When the criterion of cost-effectiveness is considered, and within the context of resource scarcity, Kenya will achieve better value for money if it prioritises investments in EC before investments in ACC. This information on cost-effectiveness will however need to be considered as part of a multicriteria decision-making framework that uses a range of criteria that reflect societal values of the Kenyan society

2019-20 coronavirus outbreak · MEDLINE · Pandemic · Political science · Disaster Response and Management · Global Maternal and Child Health · Medicine · Sepsis Diagnosis and Treatment · Internal Medicine · Virology

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