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@ARTICLE{Nguyen:210401,
author = {H. T. Nguyen and C. M. Denkinger and S. Brenner and L.
Koeppel and L. Brugnara and R. Burk and M. Knop$^*$ and T.
Bärnighausen and A. Deckert and M. De Allegri},
title = {{C}ost and cost-effectiveness of four different
{SARS}-{C}o{V}-2 active surveillance strategies: evidence
from a randomised control trial in {G}ermany.},
journal = {The European journal of health economics},
volume = {24},
number = {9},
issn = {1618-7598},
address = {Heidelberg},
publisher = {Springer},
reportid = {DKFZ-2023-00125},
pages = {1545-1559},
year = {2023},
note = {2023 Dec;24(9):1545-1559},
abstract = {The COVID-19 pandemic has entered its third year and
continues to affect most countries worldwide. Active
surveillance, i.e. testing individuals irrespective of
symptoms, presents a promising strategy to accurately
measure the prevalence of SARS-CoV-2. We aimed to identify
the most cost-effective active surveillance strategy for
COVID-19 among the four strategies tested in a randomised
control trial between 18th November 2020 and 23rd December
2020 in Germany. The four strategies included: (A1) direct
testing of individuals; (A2) direct testing of households;
(B1) testing conditioned on upstream COVID-19 symptom
pre-screening of individuals; and (B2) testing conditioned
on upstream COVID-19 symptom pre-screening of households.We
adopted a health system perspective and followed an
activity-based approach to costing. Resource consumption
data were collected prospectively from a digital individual
database, daily time records, key informant interviews and
direct observations. Our cost-effectiveness analysis
compared each strategy with the status quo and calculated
the average cost-effective ratios (ACERs) for one primary
outcome (sample tested) and three secondary outcomes
(responder recruited, case detected and asymptomatic case
detected).Our results showed that A2, with cost per sample
tested at 52,89 EURO, had the lowest ACER for the primary
outcome, closely followed by A1 (63,33 EURO). This estimate
was much higher for both B1 (243,84 EURO) and B2 (181,06
EURO).A2 (direct testing at household level) proved to be
the most cost-effective of the four evaluated strategies and
should be considered as an option to strengthen the routine
surveillance system in Germany and similar settings.},
keywords = {COVID-19 (Other) / Cost (Other) / Cost-effectiveness
(Other) / Germany (Other) / Surveillance (Other)},
cin = {A260},
ddc = {610},
cid = {I:(DE-He78)A260-20160331},
pnm = {311 - Zellbiologie und Tumorbiologie (POF4-311)},
pid = {G:(DE-HGF)POF4-311},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:36656403},
doi = {10.1007/s10198-022-01561-8},
url = {https://inrepo02.dkfz.de/record/210401},
}