ArticleValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2023
The Impact of Funding Inpatient Treatments for COVID-19 on Health Equity in the United States: A Distributional Cost-Effectiveness Analysis.
Article in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Methodological heterogeneity and equity challenges of distributional cost-effectiveness analysis in healthcare: a systematic review from 2017 to 2025.Archives of public health = Archives belges de sante publique · 2026Pooled it
- Diagnostics and treatments of COVID-19: two-year update to a living systematic review of economic evaluations.Frontiers in pharmacology · 2023Pooled it
- Distributional Cost-Effectiveness Analysis Using Microsimulation in R: A Tutorial.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- Practical Considerations for Incorporating Equity More Explicitly in Australian Health Technology Assessment Processes.PharmacoEconomics · 2026Review
- Public preferences for reducing health inequality in the US: a national survey.BMC medical ethics · 2026Article
- How to Fix a Broken Health Care System: Pathways to Maximize Health and Well-being for All.Diabetes care · 2026Review
- The Impact of Alteplase Coverage on Health Equity for the Treatment of Ischemic Stroke in the USA: A Distributional Cost-Effectiveness Analysis.Applied health economics and health policy · 2025Article
- Disparities Research in Pediatric Orthopaedic Surgery: Is the Needle Moving?Journal of pediatric orthopedics · 2025Article
- Medicaid Expansion Among Nonelderly Adults and Cardiovascular Disease: Efficiency Vs. Equity.The Milbank quarterly · 2025Article
- The Impact of Tocilizumab Coverage on Health Equity for Inpatients with COVID-19 in the USA: A Distributional Cost-Effectiveness Analysis.PharmacoEconomics · 2025Article
- Modeling the Population Equity of Alzheimer Disease Treatments in the US.JAMA network open · 2024Article
- Valuing the Societal Impact of Medicines and Other Health Technologies: A User Guide to Current Best Practices.Forum for health economics & policy · 2024Article
- Evidence of quality of life for hospitalised patients with COVID-19: a scoping review.Health technology assessment (Winchester, England) · 2024Article
- The Health Inequality Impact of Liquid Biopsy to Inform First-Line Treatment of Advanced Non-Small Cell Lung Cancer: A Distributional Cost-Effectiveness Analysis.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2023Article
- Accounting for Nonhealth and Future Costs in Cost-Effectiveness Analysis: Distributional Impacts of a US Cancer Prevention Strategy.PharmacoEconomics · 2023Article
- Distributional Cost-Effectiveness of Equity-Enhancing Gene Therapy in Sickle Cell Disease in the United States.Annals of internal medicine · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe conducted a distributional cost-effectiveness analysis (DCEA) to evaluate how Medicare funding of inpatient COVID-19 treatments affected health equity in the United States.
methodsA DCEA, based on an existing cost-effectiveness analysis model, was conducted from the perspective of a single US payer, Medicare. The US population was divided based on race and ethnicity (Hispanic, non-Hispanic black, and non-Hispanic white) and county-level social vulnerability index (5 quintile groups) into 15 equity-relevant subgroups. The baseline distribution of quality-adjusted life expectancy was estimated across the equity subgroups. Opportunity costs were estimated by converting total spend on COVID-19 inpatient treatments into health losses, expressed as quality-adjusted life-years (QALYs), using base-case assumptions of an opportunity cost threshold of $150 000 per QALY gained and an equal distribution of opportunity costs across equity-relevant subgroups.
resultsMore socially vulnerable populations received larger per capita health benefits due to higher COVID-19 incidence and baseline in-hospital mortality. The total direct medical cost of inpatient COVID-19 interventions in the United States in 2020 was estimated at $25.83 billion with an estimated net benefit of 735 569 QALYs after adjusting for opportunity costs. Funding inpatient COVID-19 treatment reduced the population-level burden of health inequality by 0.234%. Conclusions remained robust across scenario and sensitivity analyses.
conclusionsTo the best of our knowledge, this is the first DCEA to quantify the equity implications of funding COVID-19 treatments in the United States. Medicare funding of COVID-19 treatments in the United States could improve overall health while reducing existing health inequalities.
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