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Vardavas C, Zisis K, Nikitara K, Lagou I, Marou V, Aslanoglou K, Athanasakis K, Phalkey R, Leonardi-Bee J, Fernandez E, Condell O, Lamb F, Sandmann F, Pharris A, Deogan C, Suk JE. Cost of the COVID-19 pandemic versus the cost-effectiveness of mitigation strategies in EU/UK/OECD: a systematic review. BMJ Open 2023; 13:e077602. [PMID: 37907290 PMCID: PMC10619092 DOI: 10.1136/bmjopen-2023-077602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/18/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES The economic burden of COVID-19 pandemic is substantial, with both direct and indirect costs playing a significant role. DESIGN A systematic literature review was conducted to estimate the cost of the COVID-19 pandemic and the cost-effectiveness of pharmaceutical or non-pharmaceutical interventions. All cost data were adjusted to the 2021 Euro, and interventions compared with null. DATA SOURCES Ovid MEDLINE and EMBASE were searched from January 2020 through 22 April 2021. ELIGIBILITY CRITERIA Studies regarding COVID-19 outbreak or public health preparedness measures or interventions with outcome measures related to the direct and indirect costs for disease and preparedness and/or response in countries of the European Union (EU), the European Economic Area (EEA), the UK and the Organisation for Economic Co-operation and Development (OECD) of all relevant epidemiological designs which estimate cost within the selected time frame were considered eligible. DATA EXTRACTION AND SYNTHESIS Studies were searched, screened and coded independently by two reviewers with high measure of inter-rater agreement. Data were extracted to a predefined data extraction sheet. The risk of bias was assessed using the Consensus on Health Economic Criteria checklist. RESULTS We included data from 41 economic studies. Ten studies evaluated the cost of the COVID-19 pandemic, while 31 assessed the cost-benefit of public health surveillance, preparedness and response measures. Overall, the economic burden of the COVID-19 pandemic was found to be substantial. Community screening, bed provision policies, investing in personal-protective-equipment and vaccination strategies were cost-effective. Physical distancing measures were associated with health benefits; however, their cost-effectiveness was dependent on the duration, compliance and the phase of the epidemic in which it was implemented. CONCLUSIONS COVID-19 pandemic is associated with substantial short-term and long-term economic costs to healthcare systems, payers and societies, while interventions including testing and screening policies, vaccination and physical distancing policies were identified as those presenting cost-effective options to deal with the pandemic, dependent on population vaccination and the Re at the stage of the pandemic.
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Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA
| | - Konstantinos Zisis
- School of Medicine, University of Crete, Heraklion, Greece
- Department of Public Health Policy, University of West Attica, Egaleo, Greece
| | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Greece
| | - Valia Marou
- School of Medicine, University of Crete, Heraklion, Greece
| | | | | | - Revati Phalkey
- Public Health England, London, UK
- University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Centre for Evidence-Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
| | - Orla Condell
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Favelle Lamb
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Frank Sandmann
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | - Charlotte Deogan
- European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E Suk
- European Centre for Disease Prevention and Control, Solna, Sweden
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Vardavas C, Nikitara K, Aslanoglou K, Lagou I, Marou V, Phalkey R, Leonardi-Bee J, Fernandez E, Vivilaki V, Kamekis A, Symvoulakis E, Noori T, Wuerz A, Suk JE, Deogan C. Social determinants of health and vaccine uptake during the first wave of the COVID-19 pandemic: A systematic review. Prev Med Rep 2023; 35:102319. [PMID: 37564118 PMCID: PMC10410576 DOI: 10.1016/j.pmedr.2023.102319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/12/2023] Open
Abstract
Social determinants of health significantly impact population health status. The aim of this systematic review was to examine which social vulnerability factors or determinants of health at the individual or county level affected vaccine uptake within the first phase of the vaccination program. We performed a systematic review of peer-reviewed literature published from January 2020 until September 2021 in Medline and Embase (Bagaria et al., 2022) and complemented the review with an assessment of pre-print literature within the same period. We restricted our criteria to studies performed in the EU/UK/EEA/US that report vaccine uptake in the general population as the primary outcome and included various social determinants of health as explanatory variables. This review provides evidence of significant associations between the early phases of vaccination uptake for SARS-CoV-2 and multiple socioeconomic factors including income, poverty, deprivation, race/ethnicity, education and health insurance. The identified associations should be taken into account to increase vaccine uptake in socially vulnerable groups, and to reduce disparities in uptake, in particular within the context of public health preparedness for future pandemics. While further corroboration is needed to explore the generalizability of these findings across the European setting, these results confirm the need to consider vulnerable groups and social determinants of health in the planning and roll-out of SARS-CoV-2 vaccination programs and within the context of future respiratory pandemics.
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Affiliation(s)
- Constantine Vardavas
- School of Medicine, University of Crete, Heraklion, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Harvard University, Boston, MA, USA
| | | | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Valia Marou
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Revati Phalkey
- Health Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jo Leonardi-Bee
- Health Centre for Evidence Based Healthcare, School of Medicine, University of Nottingham, Nottingham, UK
| | - Esteve Fernandez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L’Hospitalet de Llobregat (Barcelona), Spain
- Tobacco Control Research Group, Institut d’Investigació Biomèdica de. Ellvitge-IDIBELL, L’Hospitalet de Llobregat (Barcelona), Spain
- School of Medicine and Health Sciences, Campus of Bellvitge, Universitat de Barcelona, Spain
- Centre of Biomedical Research Network on Respiratory Diseases (CIBERES de Enfermedaes Respiratorias), Insituto de Salud Carlos III, Madrid, Spain
| | | | | | | | - Teymur Noori
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Andrea Wuerz
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Jonathan E. Suk
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
| | - Charlotte Deogan
- Emergency Preparedness and Response Support, European Centre for Disease Prevention and Control, Solna, Sweden
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Radu-Loghin C, Mocanu K, Al Gouhmani H, Vardavas C, Lagou I, Plyta Z, Papathanasaki A, Vogiatzidaki S, Vardavas A, Tzatzarakis M, Tsatsakis A, Filippidis F, Kyriakos C, Fernandez E, Tigova O, Martinez C, Luque AML, Eremia M, Lotrean LM, Trofor A, Wenzl T, Simpson B, Powell P, Starchenko P, Bakou A, Asimaki E, Vivilaki V. EUREST-RISE: An innovative networking and training project on European Tobacco Control. Tob Prev Cessat 2023; 9:12. [PMID: 37101785 PMCID: PMC10123401 DOI: 10.18332/tpc/163137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023]
Affiliation(s)
| | - Karina Mocanu
- European Network for Smoking and Tobacco Prevention, Brussels, Belgium
| | - Hani Al Gouhmani
- European Network for Smoking and Tobacco Prevention, Brussels, Belgium
| | | | - Ioanna Lagou
- School of Medicine, University of Crete, Heraklion, Greece
| | - Zinovia Plyta
- School of Medicine, University of Crete, Heraklion, Greece
| | | | | | | | | | | | | | | | - Esteve Fernandez
- Catalan Institute of Oncology, Spain
- Bellvitge Biomedical Research Institute, Spain
- School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
- CIBER of Respiratory Diseases, Spain
| | - Olena Tigova
- Catalan Institute of Oncology, Spain
- Bellvitge Biomedical Research Institute, Spain
- School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
- CIBER of Respiratory Diseases, Spain
| | - Cristina Martinez
- Catalan Institute of Oncology, Spain
- Bellvitge Biomedical Research Institute, Spain
- School of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
- CIBER of Respiratory Diseases, Spain
| | - Anna Mar Lopez Luque
- Catalan Institute of Oncology, Spain
- Bellvitge Biomedical Research Institute, Spain
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Vardavas C, Simpson B, Vardavas A, Nikitara K, Lagou I, Tzatzarakis M, Tsatsakis A. Updates in the state of play from the Technical Group on tobacco product flavours. Tob Prev Cessat 2022. [DOI: 10.18332/tpc/151062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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