Access and Value, Pfizer Ltd, Tadworth, UK.
Modelling and Simulatio, Evidera Inc, Bethseda, MD, USA.
Expert Rev Vaccines. 2024 Jan-Dec;23(1):730-739. doi: 10.1080/14760584.2024.2383343. Epub 2024 Aug 5.
Updating vaccines is essential for combatting emerging coronavirus disease 2019 (COVID-19) variants. This study assessed the public health and economic impact of a booster dose of an adapted vaccine in the United Kingdom (UK).
A Markov-decision tree model estimated the outcomes of vaccination strategies targeting various age and risk groups in the UK. Age-specific data derived from published sources were used. The model estimated case numbers, deaths, hospitalizations, medical costs, and societal costs. Scenario analyses were conducted to explore uncertainty.
Vaccination targeting individuals aged ≥ 65 years and the high-risk population aged 12-64 years was estimated to avert 701,549 symptomatic cases, 5,599 deaths, 18,086 hospitalizations, 56,326 post-COVID condition cases, and 38,263 lost quality-adjusted life years (QALYs), translating into direct and societal cost savings of £112,174,054 and £542,758,682, respectively. The estimated economically justifiable price at willingness-to-pay thresholds of £20,000 and £30,000 per QALY was £43 and £61, respectively, from the payer perspective and £64 and £82, respectively, from the societal perspective. Expanding to additional age groups improved the public health impact.
Targeting individuals aged ≥ 65 years and those aged 12-64 years at high risk yields public health gains, but expansion to additional age groups provides additional gains.
更新疫苗对于应对新出现的 2019 年冠状病毒病(COVID-19)变种至关重要。本研究评估了在英国(UK)使用改良疫苗进行加强针接种的公共卫生和经济效益。
马尔可夫决策树模型估计了针对英国不同年龄和风险群体的疫苗接种策略的结果。使用了从已发表的来源中得出的特定年龄的数据。该模型估计了病例数、死亡人数、住院人数、医疗费用和社会成本。进行了情景分析以探索不确定性。
针对≥65 岁的个体和 12-64 岁的高风险人群的疫苗接种预计将避免 701,549 例有症状病例、5,599 例死亡、18,086 例住院、56,326 例新冠后状况病例和 38,263 例丧失质量调整生命年(QALY),分别转化为直接和社会成本节省 112,174,054 英镑和 542,758,682 英镑。从支付者的角度来看,在支付意愿阈值为 20,000 英镑和 30,000 英镑/QALY 的情况下,估计经济合理的价格分别为 43 英镑和 61 英镑,从社会的角度来看,分别为 64 英镑和 82 英镑。扩大到其他年龄组可提高公共卫生效果。
针对≥65 岁的个体和 12-64 岁的高风险人群接种疫苗可带来公共卫生效益,但扩大到其他年龄组可带来更多效益。