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J Med Econ
. 2026 Dec;29(1):1027-1045.
doi: 10.1080/13696998.2026.2644761. Epub 2026 Mar 27.
Cost-effectiveness, public health impact, and budget impact of receipt of Pfizer-BioNTech COVID-19 vaccine, LP.8.1-adapted, 2025/2026 formula among adults aged 18 years and older at high risk for severe outcomes from COVID-19 in the United States
Alon Yehoshua 1 , Manuela Di Fusco 1 , Abby E Rudolph 1 , Elizabeth Thoburn 1 , Santiago M C Lopez 1 , Josie Dodd 2 , Benjamin Yarnoff 2
Affiliations
Objectives: To assess the cost-effectiveness, public health impact, and budget impact of receiving the LP.8.1-adapted Pfizer-BioNTech COVID-19 Vaccine among United States adults aged ≥ 18 years.
Methods: A previously published economic model was adapted to compare receiving the LP.8.1-adapted Pfizer-BioNTech COVID-19 Vaccine (2025/2026 formula) versus not in adults aged 18-64 years at high risk of severe COVID-19 and all adults aged ≥ 65 years. Age-specific epidemiological inputs were derived from public health surveillance data. Clinical, cost, and vaccine effectiveness parameters were informed by published literature. The budget impact analysis was based on a hypothetical 1-million-member plan and used a payer perspective.
Results: Without vaccination, the model projected 41.5 million new symptomatic cases, 43,681 deaths, 338,252 hospitalizations, $80 billion in total costs, and 1.99 million QALYs lost among adults aged ≥18 years, with the greatest health burden observed among adults aged ≥65 years (73% of hospitalizations and 83% of deaths) and the greatest economic burden in adults aged 18 to 64 years at high risk of severe outcomes (62% of total costs). Compared to no vaccination, vaccination with the LP.8.1-adapted Pfizer-BioNTech COVID-19 vaccine (2025/2026 formula) in the populations aged 18 to 64 years and ≥18 years, respectively was projected to prevent 212,096 and 620,333 cases, 137 and 1,867 deaths, and 1,501 and 12,677 hospitalizations, resulting in incremental costs of $1.1 billion and $567 million, 2,411 and 15,430 LYs gained, 70,493 and 181,137 QALYs gained, ICERs of $16,238 and $3,137 from the societal perspective and $34,022 and $8,059 from the payer perspective. In the budget impact analysis from the payer perspective, vaccination was estimated to result in a modest budget increase.
Conclusions: Vaccinating adults at high risk of severe COVID-19 with the LP.8.1-adapted Pfizer BioNTech COVID-19 Vaccine is projected to be a cost-saving measure from the societal perspective that could reduce the public health and economic burden of COVID-19.
Keywords: COVID-19 vaccine; Cost-effectiveness; I10; I18; LP.8.1; Pfizer-BioNTech; SARS-CoV-2; United States; budget impact.
. 2026 Dec;29(1):1027-1045.
doi: 10.1080/13696998.2026.2644761. Epub 2026 Mar 27.
Cost-effectiveness, public health impact, and budget impact of receipt of Pfizer-BioNTech COVID-19 vaccine, LP.8.1-adapted, 2025/2026 formula among adults aged 18 years and older at high risk for severe outcomes from COVID-19 in the United States
Alon Yehoshua 1 , Manuela Di Fusco 1 , Abby E Rudolph 1 , Elizabeth Thoburn 1 , Santiago M C Lopez 1 , Josie Dodd 2 , Benjamin Yarnoff 2
Affiliations
- PMID: 41894410
- DOI: 10.1080/13696998.2026.2644761
Objectives: To assess the cost-effectiveness, public health impact, and budget impact of receiving the LP.8.1-adapted Pfizer-BioNTech COVID-19 Vaccine among United States adults aged ≥ 18 years.
Methods: A previously published economic model was adapted to compare receiving the LP.8.1-adapted Pfizer-BioNTech COVID-19 Vaccine (2025/2026 formula) versus not in adults aged 18-64 years at high risk of severe COVID-19 and all adults aged ≥ 65 years. Age-specific epidemiological inputs were derived from public health surveillance data. Clinical, cost, and vaccine effectiveness parameters were informed by published literature. The budget impact analysis was based on a hypothetical 1-million-member plan and used a payer perspective.
Results: Without vaccination, the model projected 41.5 million new symptomatic cases, 43,681 deaths, 338,252 hospitalizations, $80 billion in total costs, and 1.99 million QALYs lost among adults aged ≥18 years, with the greatest health burden observed among adults aged ≥65 years (73% of hospitalizations and 83% of deaths) and the greatest economic burden in adults aged 18 to 64 years at high risk of severe outcomes (62% of total costs). Compared to no vaccination, vaccination with the LP.8.1-adapted Pfizer-BioNTech COVID-19 vaccine (2025/2026 formula) in the populations aged 18 to 64 years and ≥18 years, respectively was projected to prevent 212,096 and 620,333 cases, 137 and 1,867 deaths, and 1,501 and 12,677 hospitalizations, resulting in incremental costs of $1.1 billion and $567 million, 2,411 and 15,430 LYs gained, 70,493 and 181,137 QALYs gained, ICERs of $16,238 and $3,137 from the societal perspective and $34,022 and $8,059 from the payer perspective. In the budget impact analysis from the payer perspective, vaccination was estimated to result in a modest budget increase.
Conclusions: Vaccinating adults at high risk of severe COVID-19 with the LP.8.1-adapted Pfizer BioNTech COVID-19 Vaccine is projected to be a cost-saving measure from the societal perspective that could reduce the public health and economic burden of COVID-19.
Keywords: COVID-19 vaccine; Cost-effectiveness; I10; I18; LP.8.1; Pfizer-BioNTech; SARS-CoV-2; United States; budget impact.