1
|
Kapoor R, Standaert B, Pezalla EJ, Demarteau N, Sutton K, Tichy E, Bungey G, Arnetorp S, Bergenheim K, Darroch-Thompson D, Meeraus W, Okumura LM, Tiene de Carvalho Yokota R, Gani R, Nolan T. Identification of an Optimal COVID-19 Booster Allocation Strategy to Minimize Hospital Bed-Days with a Fixed Healthcare Budget. Vaccines (Basel) 2023; 11:vaccines11020377. [PMID: 36851254 PMCID: PMC9965991 DOI: 10.3390/vaccines11020377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/17/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
Healthcare decision-makers face difficult decisions regarding COVID-19 booster selection given limited budgets and the need to maximize healthcare gain. A constrained optimization (CO) model was developed to identify booster allocation strategies that minimize bed-days by varying the proportion of the eligible population receiving different boosters, stratified by age, and given limited healthcare expenditure. Three booster options were included: B1, costing US $1 per dose, B2, costing US $2, and no booster (NB), costing US $0. B1 and B2 were assumed to be 55%/75% effective against mild/moderate COVID-19, respectively, and 90% effective against severe/critical COVID-19. Healthcare expenditure was limited to US$2.10 per person; the minimum expected expense using B1, B2, or NB for all. Brazil was the base-case country. The model demonstrated that B1 for those aged <70 years and B2 for those ≥70 years were optimal for minimizing bed-days. Compared with NB, bed-days were reduced by 75%, hospital admissions by 68%, and intensive care unit admissions by 90%. Total costs were reduced by 60% with medical resource use reduced by 81%. This illustrates that the CO model can be used by healthcare decision-makers to implement vaccine booster allocation strategies that provide the best healthcare outcomes in a broad range of contexts.
Collapse
Affiliation(s)
- Ritika Kapoor
- Evidera, PPD Singapore, 08–11, 1 Fusionopolis Walk, Singapore 138628, Singapore
| | - Baudouin Standaert
- Faculty of Medicine and Life Sciences, University of Hasselt, Agoralaan, 3590 Diepenbeek, Belgium
| | - Edmund J. Pezalla
- Enlightenment Bioconsult, LLC, 140 S Beach Street, Suite 310, Daytona Beach, FL 32114, USA
| | | | | | | | - George Bungey
- Evidera, PPD the Ark, 2nd Floor, 201 Talgarth Road, London W6 8BJ, UK
| | - Sofie Arnetorp
- Health Economics & Payer Evidence, BioPharmaceuticals R&D, AstraZeneca, 431 83 Gothenberg, Sweden
| | - Klas Bergenheim
- Health Economics & Payer Evidence, BioPharmaceuticals R&D, AstraZeneca, 431 83 Gothenberg, Sweden
| | - Duncan Darroch-Thompson
- International Market Access, Vaccines and Immune Therapies, AstraZeneca, Singapore 339510, Singapore
| | - Wilhelmine Meeraus
- Medical Evidence, Vaccines and Immune Therapies, AstraZeneca, Cambridge CB2 8PA, UK
| | - Lucas M. Okumura
- Health Economics & Payer Evidence, BioPharmaceuticals R&D, AstraZeneca, São Paulo 06709-000, Brazil
| | - Renata Tiene de Carvalho Yokota
- Medical Evidence, Vaccines and Immune Therapies, AstraZeneca, Cambridge CB2 8PA, UK
- P95 Epidemiology & Pharmacovigilance, 3001 Leuven, Belgium
| | - Ray Gani
- Evidera, PPD the Ark, 2nd Floor, 201 Talgarth Road, London W6 8BJ, UK
- Correspondence: ; Tel.: +44-(0)-7720088940
| | - Terry Nolan
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC 3010, Australia
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
| |
Collapse
|