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Willem L, Abrams S, Franco N, Coletti P, Libin PJK, Wambua J, Couvreur S, André E, Wenseleers T, Mao Z, Torneri A, Faes C, Beutels P, Hens N. The impact of quality-adjusted life years on evaluating COVID-19 mitigation strategies: lessons from age-specific vaccination roll-out and variants of concern in Belgium (2020-2022). BMC Public Health 2024; 24:1171. [PMID: 38671366 PMCID: PMC11047051 DOI: 10.1186/s12889-024-18576-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND When formulating and evaluating COVID-19 vaccination strategies, an emphasis has been placed on preventing severe disease that overburdens healthcare systems and leads to mortality. However, more conventional outcomes such as quality-adjusted life years (QALYs) and inequality indicators are warranted as additional information for policymakers. METHODS We adopted a mathematical transmission model to describe the infectious disease dynamics of SARS-COV-2, including disease mortality and morbidity, and to evaluate (non)pharmaceutical interventions. Therefore, we considered temporal immunity levels, together with the distinct transmissibility of variants of concern (VOCs) and their corresponding vaccine effectiveness. We included both general and age-specific characteristics related to SARS-CoV-2 vaccination. Our scenario study is informed by data from Belgium, focusing on the period from August 2021 until February 2022, when vaccination for children aged 5-11 years was initially not yet licensed and first booster doses were administered to adults. More specifically, we investigated the potential impact of an earlier vaccination programme for children and increased or reduced historical adult booster dose uptake. RESULTS Through simulations, we demonstrate that increasing vaccine uptake in children aged 5-11 years in August-September 2021 could have led to reduced disease incidence and ICU occupancy, which was an essential indicator for implementing non-pharmaceutical interventions and maintaining healthcare system functionality. However, an enhanced booster dose regimen for adults from November 2021 onward could have resulted in more substantial cumulative QALY gains, particularly through the prevention of elevated levels of infection and disease incidence associated with the emergence of Omicron VOC. In both scenarios, the need for non-pharmaceutical interventions could have decreased, potentially boosting economic activity and mental well-being. CONCLUSIONS When calculating the impact of measures to mitigate disease spread in terms of life years lost due to COVID-19 mortality, we highlight the impact of COVID-19 on the health-related quality of life of survivors. Our study underscores that disease-related morbidity could constitute a significant part of the overall health burden. Our quantitative findings depend on the specific setup of the interventions under review, which is open to debate or should be contextualised within future situations.
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Affiliation(s)
- Lander Willem
- Department of Family Medicine and Population Health, Antwerp, Belgium.
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium.
| | - Steven Abrams
- Department of Family Medicine and Population Health, Antwerp, Belgium
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Nicolas Franco
- Data Science Institute, Hasselt University, Hasselt, Belgium
- Namur Institute for Complex Systems (naXys) and Department of Mathematics, University of Namur, Namur, Belgium
| | - Pietro Coletti
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Pieter J K Libin
- Data Science Institute, Hasselt University, Hasselt, Belgium
- Artificial Intelligence Lab, Vrije Universiteit Brussel, Brussels, Belgium
- Rega Institute for Medical Research, Clinical and Epidemiological Virology, University of Leuven, Leuven, Belgium
| | - James Wambua
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Simon Couvreur
- Department of Epidemiology and public health, Sciensano, Brussel, Belgium
| | - Emmanuel André
- National Reference Centre for Respiratory Pathogens, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, University of Leuven, Leuven, Belgium
| | - Tom Wenseleers
- Laboratory of Socioecology and Social Evolution, University of Leuven, Leuven, Belgium
| | - Zhuxin Mao
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
| | - Andrea Torneri
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Christel Faes
- Data Science Institute, Hasselt University, Hasselt, Belgium
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
- School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia
| | - Niel Hens
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
- Data Science Institute, Hasselt University, Hasselt, Belgium
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Nagano M, Kamei K, Matsuda H, Takahashi C, Yang J, Wada K, Yonemoto N. Cost-effectiveness analysis of COVID-19 booster vaccination with BNT162b2 in Japan. Expert Rev Vaccines 2024; 23:349-361. [PMID: 38411109 DOI: 10.1080/14760584.2024.2323133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND The aim of this study was to evaluate the public health and economic impact of the COVID-19 booster vaccination with BNT162b2 in Japan during an Omicron-dominant period from early 2022. RESEARCH DESIGN AND METHODS A combined cohort Markov decision tree model estimated the cost-effectiveness of annual or biannual booster vaccination strategies compared to no booster vaccination for those aged 65 years and above, and those aged 60-64 years at high risk as the base case. The societal perspective was primarily considered. We also examined other target populations with different age and risk groups. Sensitivity and scenario analyses with alternative inputs were performed. RESULTS Annual and biannual vaccination strategies were dominant from the societal perspective in the base case. Incremental Cost Effectiveness Ratios (ICERs) from the payer perspective were JPY 1,752,499/Quality Adjusted Life Year (QALY) for annual vaccination and JPY 2,831,878/QALY for biannual vaccination, both less than the threshold value in Japan (JPY 5 million/QALY). The results were consistent even when examining other target age and risk groups. All sensitivity and scenario analyses indicated that ICERs were below JPY 5 million/QALY. CONCLUSIONS Booster vaccination with the COVID-19 vaccine BNT162b2 is a dominant strategy and beneficial to public health in Japan.
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Affiliation(s)
| | | | | | | | - Jingyan Yang
- Global Access and Value, Pfizer Inc., New York, NY, USA
- Institute for Social and Economic Research and Policy, Columbia University, New York, NY, USA
| | - Koji Wada
- mRNA & Antiviral Medical Affairs, Pfizer Japan Inc., Tokyo, Japan
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Choi W, Shim E. Assessing the cost-effectiveness of annual COVID-19 booster vaccination in South Korea using a transmission dynamic model. Front Public Health 2023; 11:1280412. [PMID: 38074736 PMCID: PMC10701673 DOI: 10.3389/fpubh.2023.1280412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/19/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction We evaluated the cost-effectiveness of South Korea's planned annual coronavirus disease 2019 (COVID-19) booster campaign scheduled for October 2023. Materials and methods An age-structured mathematical model was used to analyze the public impacts and cost-effectiveness of vaccination across three vaccination strategies: uniform allocation and prioritizing those over 65 or those over 50 years old. We calculated the incremental cost per quality-adjusted life year (QALY) from both healthcare and societal perspectives. The maximum vaccine cost for cost-effectiveness was also identified. Results Our analysis highlights the cost-effectiveness of South Korea's annual COVID-19 vaccination program in mitigating health and economic impacts. The most cost-effective strategy is uniform vaccine allocation, offering the lowest incremental cost-effectiveness ratio (ICER) at US$ 25,787/QALY. However, with a relatively high attack rate, the strategy prioritizing individuals over 65 years emerges as more cost-effective, lowering the ICER to US$ 13,785/QALY. Prioritizing those over 50 was less cost-effective. All strategies were cost-saving from a societal perspective, with cost-effectiveness being more sensitive to vaccine price than to its effectiveness. Discussion Our results imply a potential strategy shift in current vaccination plan, with uniform vaccine distribution being more cost-effective than prioritizing older adults. Early estimation of viral transmissibility and vaccine effectiveness is crucial in determining the most cost-effective vaccine allocation approach.
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Affiliation(s)
| | - Eunha Shim
- Department of Mathematics, Soongsil University, Seoul, Republic of Korea
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