Objective: To estimate and compare the cost-effectiveness of COVID-19 critical care intervention approaches: noninvasive (oxygen without intubation) and invasive (intubation) management in Ethiopia.
Methods: A Markov model using both primary and secondary data was used to compare costs and outcomes for noninvasive and invasive COVID-19 clinical interventions. Healthcare provider costs (recurrent and capital cost) and patient-side (direct and indirect) costs were estimated and reported in United States Dollar (US$), 2021 The outcome measure used in this analysis was DALYs averted. Both the average cost-effectiveness ratio (ACER) and incremental cost-effectiveness ratio (ICER) were reported. One-way and probabilistic sensitivity analyses were applied to assess the robustness of the findings. The analysis is conducted using TreeAge pro health care software 2022.
Result: The average cost per patient per episode for mild/moderate, severe, noninvasive, and invasive critical management were $951, $3,449, $5,514, and $6,500, respectively. According to the average costeffective ratio (ACER), non-invasive management resulted in $1,991 per DALY averted, while invasive management resulted in $3,998 per DALY averted. Similarly, the incremental cost-effective ratio (ICER) of invasive compared to noninvasive management was $ 4,948 per DALY averted.
Conclusion: The clinical management of critical COVID-19 cases in Ethiopia carries high cost. Invasive intervention is unlikely to be a cost-effective COVID-19 intervention in Ethiopia compared to noninvasive critical case management using a willingness to pay threshold of three times GDP per capita.
Keywords: COVID-19, Cost, Cost-effectiveness, Critical. Invasive, Noninvasive
