15 March 2020; the day that the Netherlands went into lockdown. The one-year anniversary is around the corner. What does the COVID19 crisis and the COVID19 vaccinations cost the Netherlands? Maarten Postma, professor of Global Health Economics, does the sum.

Postma explains that the GNP of the Netherlands is 400 billion euros per year: "If the economic growth of the Netherlands contracts by five percent a year, that comes to 20 billion. Dividing 20 billion by 365 means 50 million euros a day. This will be an underestimate because the government support from the corona support fund is already almost 40 billion. Possibly, the amount is more than 100 million euros a day."

On 6 January 2021, the vaccination campaign in the Netherlands was launched; nursing home employee Sanna from Eindhoven received the first vaccination in the Netherlands. What are the costs for the Netherlands to vaccinate its residents?

Postma: For the vaccination itself, I will charge half a GP consultation of 10 euros, this is the same as for the flu. The cost of the vaccines varies from 2 euros to 18 euros per dose. Let's assume an average of 10 euros, so two vaccines per person would cost 20 euros. For now, children are not vaccinated and not everyone takes the vaccine, so about 10 million Dutch people will be vaccinated. Although this would still be an underestimate I think. If we want to vaccinate 10 million Dutch people, it will cost 300 million euros."

When is a medicine/vaccination cost-effective? For this, Postma uses the term QALY (quality-adjusted life year), which is used in a cost-utility analysis, an economic consideration of the sense and effectiveness of a healthcare treatment. It stands for an extra year of life in good health. Postma: "For vaccines in general, we use 20.000 euros per QALY; for COVID19 this limit will be higher because of the severity, possibly to 50 or 80.000 euros per QALY."

Is there a chance that commercial vaccination will become available? "In the Netherlands, commercial vaccination is still extremely uncommon," says Postma, "although meningococcal B is not in the National Vaccination Programme, you do see some commercial use there (at your own expense), but for COVID19 it will be seen as unacceptable because of health differences. Possibly something will arise that people will want the more expensive Pfizer vaccine and suggest they are willing to pay for it... but it's very un-Dutch with vaccinations. I don't see that happening."

This blog was originally published on the website of the Aletta Jacobs School of Public Health.

For more information, please contact professor Maarten Postma, m.j.postma rug.nl.