tetano
Editor, Senior Moderator
J Med Econ
. 2023 Nov 14:1-22.
doi: 10.1080/13696998.2023.2281083. Online ahead of print. The potential clinical impact and cost-effectiveness of the updated COVID-19 mRNA fall 2023 vaccines in the United States
Michele A Kohli[SUP] 1 [/SUP], Michael Maschio[SUP] 1 [/SUP], Keya Joshi[SUP] 2 [/SUP], Amy Lee[SUP] 1 [/SUP], Kelly Fust[SUP] 1 [/SUP], Ekkehard Beck[SUP] 2 [/SUP], Nicolas Van de Velde[SUP] 2 [/SUP], Milton C Weinstein[SUP] 3 [/SUP]
Affiliations
Aims: To assess the potential clinical impact and cost-effectiveness of COVID-19 mRNA vaccines updated for fall 2023 in adults ≥18 years over a 1-year analytic time horizon (September 2023-August 2024).
Materials and methods: A compartmental Susceptible-Exposed-Infected-Recovered model was updated to reflect COVID-19 cases in summer 2023. The numbers of symptomatic infections, COVID-19-related hospitalizations and deaths, and costs and quality-adjusted life-years (QALYs) gained were calculated using a decision tree model. The incremental cost-effectiveness ratio (ICER) of a Moderna updated mRNA fall 2023 vaccine (Moderna Fall Campaign) was compared to no additional vaccination. Potential differences between the Moderna and the Pfizer-BioNTech fall 2023 vaccines were also examined.
Results: Base case results suggest that the Moderna Fall Campaign would decrease the expected 64.2 million symptomatic infections by 7.2 million (11%) to 57.0 million. COVID-19-related hospitalizations and deaths are expected to decline by 343,000 (-29%) and 50,500 (-33%), respectively. The Moderna Fall Campaign would increase QALYs by 740,880 and healthcare costs by $5.7 billion relative to no vaccine, yielding an ICER of $7700 per QALY gained. Using a societal cost perspective, the ICER is $2100. Sensitivity analyses suggest that vaccine effectiveness, COVID-19 incidence, hospitalization rates, and costs drive cost-effectiveness. With a relative vaccine effectiveness of 5.1% for infection and 9.8% for hospitalization for the Moderna vaccine versus the Pfizer-BioNTech vaccine, use of the Moderna vaccine is expected to prevent 24,000 more hospitalizations and 3300 more deaths than the Pfizer-BioNTech vaccine.
Limitations and conclusions: As COVID-19 becomes endemic, future incidence, including patterns of infection, are highly uncertain. The effectiveness of fall 2023 vaccines is unknown, and it is unclear when a new variant that evades natural or vaccine immunity will emerge. Despite these limitations, our model predicts the Moderna Fall Campaign vaccine is highly cost-effective across all sensitivity analyses.
Keywords: COVID-19; H; H00; I; I00; SARS-CoV-2; United States; coronavirus; cost-effectiveness; vaccination.
. 2023 Nov 14:1-22.
doi: 10.1080/13696998.2023.2281083. Online ahead of print. The potential clinical impact and cost-effectiveness of the updated COVID-19 mRNA fall 2023 vaccines in the United States
Michele A Kohli[SUP] 1 [/SUP], Michael Maschio[SUP] 1 [/SUP], Keya Joshi[SUP] 2 [/SUP], Amy Lee[SUP] 1 [/SUP], Kelly Fust[SUP] 1 [/SUP], Ekkehard Beck[SUP] 2 [/SUP], Nicolas Van de Velde[SUP] 2 [/SUP], Milton C Weinstein[SUP] 3 [/SUP]
Affiliations
- PMID: 37961887
- DOI: 10.1080/13696998.2023.2281083
Aims: To assess the potential clinical impact and cost-effectiveness of COVID-19 mRNA vaccines updated for fall 2023 in adults ≥18 years over a 1-year analytic time horizon (September 2023-August 2024).
Materials and methods: A compartmental Susceptible-Exposed-Infected-Recovered model was updated to reflect COVID-19 cases in summer 2023. The numbers of symptomatic infections, COVID-19-related hospitalizations and deaths, and costs and quality-adjusted life-years (QALYs) gained were calculated using a decision tree model. The incremental cost-effectiveness ratio (ICER) of a Moderna updated mRNA fall 2023 vaccine (Moderna Fall Campaign) was compared to no additional vaccination. Potential differences between the Moderna and the Pfizer-BioNTech fall 2023 vaccines were also examined.
Results: Base case results suggest that the Moderna Fall Campaign would decrease the expected 64.2 million symptomatic infections by 7.2 million (11%) to 57.0 million. COVID-19-related hospitalizations and deaths are expected to decline by 343,000 (-29%) and 50,500 (-33%), respectively. The Moderna Fall Campaign would increase QALYs by 740,880 and healthcare costs by $5.7 billion relative to no vaccine, yielding an ICER of $7700 per QALY gained. Using a societal cost perspective, the ICER is $2100. Sensitivity analyses suggest that vaccine effectiveness, COVID-19 incidence, hospitalization rates, and costs drive cost-effectiveness. With a relative vaccine effectiveness of 5.1% for infection and 9.8% for hospitalization for the Moderna vaccine versus the Pfizer-BioNTech vaccine, use of the Moderna vaccine is expected to prevent 24,000 more hospitalizations and 3300 more deaths than the Pfizer-BioNTech vaccine.
Limitations and conclusions: As COVID-19 becomes endemic, future incidence, including patterns of infection, are highly uncertain. The effectiveness of fall 2023 vaccines is unknown, and it is unclear when a new variant that evades natural or vaccine immunity will emerge. Despite these limitations, our model predicts the Moderna Fall Campaign vaccine is highly cost-effective across all sensitivity analyses.
Keywords: COVID-19; H; H00; I; I00; SARS-CoV-2; United States; coronavirus; cost-effectiveness; vaccination.