Hmm… Here’s how I understand your estimate. Is that a fair summary?
If all had gone according to a perfectly happy timeline where everyone makes the right decisions, we could have had enough vaccines in August.
This would be worth approximately 205 million QALYs.
It would also cost approximately 0.7 trillion dollars.
That’s 3400 dollars per QALY.
My concern (expressed in the comments above) is mainly that the happy timeline is unrealistic, so the estimate could be off by a large factor, similarly to how the time and cost estimates of our plans are often off by a large factor.
Your estimate is probably still valuable, even if it is imprecise. We can use it to think about whether vaccine development is cost-effective; I reckon 3400$/QALY puts the cost-effectiveness an order of magnitude below effective charities and some orders of magnitude above many other public health interventions. Is that a fair conclusion?
I’d like to take away more from your post than just the estimate, but am not sure at the moment what other recommendations I can take from it...
The estimate undersells long COVID because we don’t know how many years of 3.2m QALYs to add, but yes that’s roughly it. And yes, I only claim that it was a decent deal, particularly since the funding for it couldn’t really have gone on something else.
I freely admit that it could be off by a large factor (see my final paragraph). I would love for someone to come and do a proper Bayesian interval version, which would foreground the uncertainty.
I continue to challenge calling it “unrealistic”, on priors, just because it’s very uncertain. Last January, a historical baseline would have called it unrealistic to expect completion of vaccine R&D, trials, approvals, and distribution in 11 months. But here we are. I would have you be less sure about what’s not possible, or not realistic.
Hmm… Here’s how I understand your estimate. Is that a fair summary?
If all had gone according to a perfectly happy timeline where everyone makes the right decisions, we could have had enough vaccines in August.
This would be worth approximately 205 million QALYs.
It would also cost approximately 0.7 trillion dollars.
That’s 3400 dollars per QALY.
My concern (expressed in the comments above) is mainly that the happy timeline is unrealistic, so the estimate could be off by a large factor, similarly to how the time and cost estimates of our plans are often off by a large factor.
Your estimate is probably still valuable, even if it is imprecise. We can use it to think about whether vaccine development is cost-effective; I reckon 3400$/QALY puts the cost-effectiveness an order of magnitude below effective charities and some orders of magnitude above many other public health interventions. Is that a fair conclusion?
I’d like to take away more from your post than just the estimate, but am not sure at the moment what other recommendations I can take from it...
The estimate undersells long COVID because we don’t know how many years of 3.2m QALYs to add, but yes that’s roughly it. And yes, I only claim that it was a decent deal, particularly since the funding for it couldn’t really have gone on something else.
I freely admit that it could be off by a large factor (see my final paragraph). I would love for someone to come and do a proper Bayesian interval version, which would foreground the uncertainty.
I continue to challenge calling it “unrealistic”, on priors, just because it’s very uncertain. Last January, a historical baseline would have called it unrealistic to expect completion of vaccine R&D, trials, approvals, and distribution in 11 months. But here we are. I would have you be less sure about what’s not possible, or not realistic.