Jiang Yawen, Cai Dan, Shi Si
Sun Yat-sen University School of Public Health (Shenzhen), Shenzhen, Guangdong, China.
Infect Dis Model. 2022 Mar;7(1):109-121. doi: 10.1016/j.idm.2021.12.002. Epub 2021 Dec 10.
The present study aimed to document the economic profiles of inactivated COVID-19 vaccines in Hong Kong SAR, Indonesia, mainland China, Philippines, Singapore, and Thailand, the evidence on which is currently absent.
Decision tree models were developed to assess the cost-effectiveness of two doses of inactivated COVID-19 vaccines at a population vaccination rate of 50% in the base case, which was an estimate of feasible vaccination coverage according to previous studies. Epidemiological, mortality, cost, and health state utility information were sourced from the literature. Vaccine efficacy against COVID-19 cases by severity were estimated using meta-analyses of publicly accessible phase 3 trial results of inactivated vaccines. The health outcomes were quantified as quality-adjusted life years (QALYs) and compared across the vaccination and no vaccination strategies. In scenario analyses, incidence and vaccination rates were changed semi-continuously over spectrums, the results of which were presented as contour lines informing the efficiency frontiers of vaccination strategies. One-way and probabilistic sensitivity analyses were also conducted.
The vaccination strategy was dominant in all jurisdictions in the base case by producing 105.18, 98.15, 99.70, 60.48, 112.00, and 103.47 QALYs while saving US$40.26 million, US$5.26 million, US$7.60 million, US$5.91 million, US$21.33 million, and US$7.18 million in Hong Kong SAR, Indonesia, mainland China, Philippines, Singapore, and Thailand per every 100,000 vaccinated individuals, respectively. Results were robust in alternative model specifications.
Inactivated COVID-19 vaccines may be cost-saving options in Hong Kong SAR, Indonesia, mainland China, Philippines, Singapore, and Thailand. Mass vaccination programs using inactivated COVID-19 vaccines should be considered in these jurisdictions.
本研究旨在记录中国香港特别行政区、印度尼西亚、中国大陆、菲律宾、新加坡和泰国的新冠病毒灭活疫苗的经济概况，目前尚无相关证据。
建立决策树模型，以评估在基本情况下，两剂新冠病毒灭活疫苗在50%的人群接种率下的成本效益，这是根据以往研究对可行接种覆盖率的估计。流行病学、死亡率、成本和健康状态效用信息均来自文献。通过对公开可得的灭活疫苗3期试验结果进行荟萃分析，估算疫苗针对不同严重程度新冠病例的效力。将健康结果量化为质量调整生命年（QALYs），并在接种和未接种策略之间进行比较。在情景分析中，发病率和接种率在一定范围内半连续变化，其结果以等高线形式呈现，以说明接种策略的效率前沿。还进行了单向和概率敏感性分析。
在基本情况下，接种策略在所有司法管辖区均占主导地位，每10万名接种者分别在香港特别行政区、印度尼西亚、中国大陆、菲律宾、新加坡和泰国产生105.18、98.15、99.70、60.48、112.00和103.47个QALYs，同时分别节省4026万美元、526万美元、760万美元、591万美元、2133万美元和718万美元。在替代模型规格下结果依然稳健。
新冠病毒灭活疫苗在香港特别行政区、印度尼西亚、中国大陆、菲律宾、新加坡和泰国可能是节省成本的选择。这些司法管辖区应考虑采用新冠病毒灭活疫苗开展大规模接种计划。
