Cost-effectiveness of enhancing genomic surveillance to control COVID-19 in India
Center for Global Development Europe
Background
During the COVID-19 pandemic, genomic surveillance was crucial for early outbreak detection, devising intervention and tracking progress. Whole Genome Sequencing (WGS) surveillance aids epidemiological surveillance of pathogens and clinical decision-making on infectious diseases. However, high sequencing costs limit the testing of infections, particularly in LMICs where data on the benefits of WGS is largely missing.
About the Study
A national-level pathogen genomic surveillance network and the impact of sequencing capacity, sampling proportion of positive sample, variant characteristics on novel variant detection time and total costs incurred.
Methodology
We formulated a framework by integrating surveillance network operations and the transmission dynamics of the pathogen. The cost-effectiveness of genome sequencing surveillance operations is assessed by comparing the total cost of sequencing and intervention to life-years saved.
Key Findings
Cost-effectiveness: As per WHO standards of cost-effectiveness of interventions, genome sequencing-based surveillance is cost-effective for a wide range of operational and epidemiological parameters.
Sequencing Network Configuration: “Optimal” cost-effective operational configuration varies based on novel variant characteristics and emergence time.
Sequencing Proportion: Sequencing many cases does not necessarily lead to a more cost-effective intervention. Processing more samples with limited laboratory capacity can increase queue times and lead to delays in obtaining results. These delays may reduce the timeliness of public health responses.
Our cost-effectiveness model can be used to estimate and justify the additional funding required for WGS-based surveillance to be incorporated into integrated disease surveillance programs (beyond COVID-19).