日本老年人接种NVX-CoV2373新冠疫苗的成本效益分析。
Cost-effectiveness analysis of NVX-CoV2373 COVID-19 vaccination for elderly people in Japan.
作者信息
Kato Masafumi, Ono Takayori, Deguchi Hisato, Ohmagari Norio, Igarashi Ataru
机构信息
Market Access, Public Affairs & Patient Experience, Japan Pharma Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan.
Medical Franchise Vaccine, Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan.
出版信息
Vaccine X. 2024 Jun 20;19:100514. doi: 10.1016/j.jvacx.2024.100514. eCollection 2024 Aug.
BACKGROUND
NVX-CoV2373 is one of the vaccines marketed for COVID-19 prevention in Japan. Information on its cost-effectiveness is important for making well-informed decisions on the future of Japan's COVID-19 vaccination programme from the public healthcare payer's perspective. The aim of this study was to evaluate the cost-effectiveness of NVX-CoV2373 vaccination in the elderly Japanese population.
METHODS
Two analysis populations that included elderly Japanese individuals (aged ≥ 65 years) were defined in this study: those who had not received a COVID-19 vaccine or had not completed a primary vaccination series (i.e., first two vaccinations) with an approved COVID-19 vaccine (analysis population 1), and those who had received two primary vaccinations with an approved COVID-19 vaccine (analysis population 2). A literature-informed Markov model for each analysis population was developed to evaluate the cost-effectiveness of vaccination with NVX-CoV2373 against no vaccination with NVX-CoV2373 from the public healthcare payer's perspective as a base-case analysis and from the societal perspective as a scenario analysis. Vaccine efficacy was estimated from a phase 3 study of NVX-CoV2373 (EudraCT number: 2020-004123-16). Cost-effectiveness was assessed using a willingness-to-pay threshold of Japanese yen (JPY) 5 million per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses were also performed.
RESULTS
For analysis population 1, NVX-CoV2373 primary and booster vaccinations would reduce costs by JPY 37,647 and prolong QALYs by 0.01601. Therefore, NVX-CoV2373 primary and booster vaccinations were considered to be dominant over no vaccination. For analysis population 2, an NVX-CoV2373 booster vaccination would increase costs by JPY 5010 and prolong QALYs by 0.00550, with the incremental cost-effectiveness ratio of JPY 910,566 per QALY gained.
CONCLUSIONS
Our analyses suggest that a vaccination strategy with NVX-CoV2373 is cost-effective in the elderly population (aged ≥ 65 years) of Japan
背景
NVX-CoV2373是日本市场上用于预防新冠病毒病（COVID-19）的疫苗之一。从公共医疗支付方的角度来看，了解其成本效益对于就日本COVID-19疫苗接种计划的未来做出明智决策非常重要。本研究的目的是评估NVX-CoV2373疫苗接种在日本老年人群体中的成本效益。
方法
本研究定义了两个分析人群，均为日本老年个体（年龄≥65岁）：未接种过COVID-19疫苗或未完成经批准的COVID-19疫苗的基础免疫接种程序（即前两剂疫苗接种）的人群（分析人群1），以及已接种两剂经批准的COVID-19疫苗的人群（分析人群2）。针对每个分析人群建立了一个基于文献的马尔可夫模型，以从公共医疗支付方的角度作为基础病例分析以及从社会角度作为情景分析，评估接种NVX-CoV2373疫苗与不接种NVX-CoV2373疫苗相比的成本效益。疫苗效力是根据NVX-CoV2373的一项3期研究（欧洲临床试验注册号：2020-004123-16）估算得出的。使用每质量调整生命年（QALY）500万日元（JPY）的支付意愿阈值评估成本效益。还进行了确定性和概率性敏感性分析。
结果
对于分析人群1，接种NVX-CoV2373疫苗进行基础免疫和加强免疫将使成本降低37,647日元，并使QALY延长0.01601。因此，接种NVX-CoV2373疫苗进行基础免疫和加强免疫被认为比不接种更具优势。对于分析人群2，接种NVX-CoV2373疫苗进行加强免疫将使成本增加5010日元，并使QALY延长0.00550，每获得一个QALY的增量成本效益比为910,566日元。
结论
我们的分析表明，在日本老年人群体（年龄≥65岁）中，采用NVX-CoV2373的疫苗接种策略具有成本效益。
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