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英国更新的 COVID-19 mRNA 2024 年秋季疫苗的潜在临床影响和成本效益。

The potential clinical impact and cost-effectiveness of the updated COVID-19 mRNA Autumn 2024 vaccines in the United Kingdom.

机构信息

Quadrant Health Economics Inc, Cambridge, Canada.

Moderna, Inc, Cambridge, MA, USA.

出版信息

J Med Econ. 2024 Jan-Dec;27(1):1359-1372. doi: 10.1080/13696998.2024.2413288. Epub 2024 Nov 8.

Abstract

AIMS

To estimate the potential clinical impact and cost-effectiveness of a United Kingdom (UK) Autumn 2024 vaccination campaign with an updated Moderna COVID-19 vaccine in adults ≥65 years and eligible persons 6 months to 64 years of age over a 1-year time horizon (September 2024-August 2025).

MATERIALS AND METHODS

A compartmental Susceptible-Exposed-Infected-Recovered model was adapted to reflect COVID-19 cases in the UK. Numbers of symptomatic infections, COVID-19-related hospitalizations and deaths, costs, and quality-adjusted life-years (QALYs) were predicted using a decision tree. The incremental cost-effectiveness ratio (ICER) of an updated Moderna mRNA vaccine (Moderna Autumn 2024 Campaign) was compared to No Autumn 2024 vaccine and to an updated Pfizer-BioNTech mRNA Autumn 2024 vaccine, from a healthcare perspective.

RESULTS

The Moderna Autumn 2024 Vaccination Campaign is predicted to decrease the expected 8.3 million symptomatic infections with no vaccination by 19% to 6.7 million. Hospitalizations, long COVID cases, and deaths are expected to decline by 27,000 (-38%), 59,000 (-19%), and 6,000 (-43%), respectively. The Moderna Autumn 2024 Campaign will increase QALYs by 78,000 and costs by £665 million, yielding an ICER of £8,500/QALY gained. Sensitivity analyses suggest that vaccine effectiveness (VE) and waning, symptomatic infection incidence, hospitalization rates, and mortality rates drive cost-effectiveness. Vaccination remains cost-effective when lowering the target population to ≥50 years. Use of the Moderna vaccine is expected to prevent 8,000 more hospitalizations and 1,700 more deaths than the updated Pfizer-BioNTech vaccine.

CONCLUSIONS

Vaccination of the eligible population would contribute to significant reductions in hospitalizations, deaths, and long COVID in the UK in the 2024-2025 season. Expanding the target population continues to be cost-effective. Use of the Moderna Autumn 2024 Campaign is predicted to reduce SARS-CoV-2 infections and associated outcomes in a cost-effective manner and will contribute to a more resilient healthcare system in the UK.

摘要

目的

估计在英国(UK)2024 年秋季对 65 岁及以上成年人和 6 个月至 64 岁符合条件的人群进行更新的 Moderna COVID-19 疫苗接种活动的潜在临床影响和成本效益,时间范围为 1 年(2024 年 9 月至 2025 年 8 月)。

材料和方法

改编了一个隔室易感-暴露-感染-恢复模型,以反映英国的 COVID-19 病例。使用决策树预测有症状感染、COVID-19 相关住院和死亡人数、成本和质量调整生命年(QALYs)。从医疗保健角度来看,将更新的 Moderna mRNA 疫苗(Moderna 2024 年秋季疫苗接种活动)与不进行 2024 年秋季疫苗接种和更新的 Pfizer-BioNTech mRNA 2024 年秋季疫苗接种进行比较,评估其增量成本效益比(ICER)。

结果

预计 Moderna 2024 年秋季疫苗接种活动将使没有疫苗接种的预期 830 万例有症状感染减少 19%,降至 670 万例。住院、长期 COVID 病例和死亡人数预计将分别下降 27,000 例(38%)、59,000 例(19%)和 6,000 例(43%)。Moderna 2024 年秋季疫苗接种活动将增加 78,000 个 QALYs 并增加 6.65 亿英镑的成本,ICER 为每获得 1 个 QALY 增加 8500 英镑。敏感性分析表明,疫苗效力(VE)和衰减、有症状感染发生率、住院率和死亡率是影响成本效益的因素。将目标人群降低到≥50 岁,疫苗接种仍然具有成本效益。使用 Moderna 疫苗预计将比更新的 Pfizer-BioNTech 疫苗减少 8000 例住院和 1700 例死亡。

结论

在 2024-2025 年季节,对符合条件的人群进行疫苗接种将有助于显著减少英国的住院、死亡和长期 COVID。扩大目标人群仍然具有成本效益。预计 Moderna 2024 年秋季疫苗接种活动将以具有成本效益的方式降低 SARS-CoV-2 感染及其相关结果,并为英国更具弹性的医疗保健系统做出贡献。

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