The Cost-Effectiveness of a COVID-19 Vaccine in a Danish Context

Abstract

Background and ObjectivesCovid-19 vaccines approved by the EU, UK and USA have been found to be safe and effective. The cost effectiveness of these vaccines depends upon a number of factors. The aim of this paper is to explore the cost effectiveness of a COVID-19 vaccine and to analyse how the price of the vaccine and the cost of administrating it influence its cost effectiveness. Methods We considered an epidemiological model developed by an expert group within 'Statens Serum Institut', which is a unit under the auspices of the Danish Ministry of Health. The model allowed us to differentiate between two population groups, those aged ≥60 years and those aged <60 years. We used the model to consider four scenarios: (i) vaccination of 25% of the total population (corresponding to approximately 1.5 million persons) but targeting vaccines towards the population aged ≥60 years, (ii) vaccination of 25% of the total population, targeting vaccines only towards the population aged <60 years, (iii) vaccination of 40% of the total population where 15% are aged <60 years and 25% are aged ≥60 years (corresponding approximately to the full Danish population aged >60 years), and (iv) 40% of the total population is vaccinated but vaccines are targeted solely towards those aged <60 years. The time horizon of the analysis was six months, and the perspective was that of the Danish healthcare sector. ResultsThe results show that inclusion of the elderly population aged ≥60 years was more cost effective than a vaccination strategy that targeted a population aged <60 years old only, when productivity losses were not included. Furthermore, the results show that an extension of the target group from the elderly population only, to also include the younger population comes with an increasing cost per life-year gained. The incremental cost-effectiveness ratio depends on the price of the vaccine, hereunder also the administration costs, and the discount rate used for the estimation of life-years or quality-adjusted life-years gained from a vaccine. Furthermore, inclusion of productivity losses in the analyses influenced the cost effectiveness of vaccination of the population aged <60 years of age. ConclusionThe cost effectiveness of a COVID-19 vaccine is sensitive to whether or not productivity losses are included in the analyses. Without productivity losses, the elderly population should always be part of the target group for a COVID-19 vaccination programme. Taking productivity losses into account, at least in the case of low vaccine prices, vaccinating the younger population first can actually be cost effective.

Effectiveness and Cost-Effectiveness of Inactivated Vaccine to Address COVID-19 Pandemic in China: Evidence From Randomized Control Trials and Real-World Studies

“…Our results were consistent with previous cost-effectiveness studies and can improve their findings as these studies were done at the early stage of the COVID-19 pandemic with insufficient data on the efficacy and vaccine cost. Specifically, evidence from high-income countries showed that in general vaccination was cost-saving (43)(44)(45) and cost-effective (46,47), and the whole society can benefit from vaccination even when the coverage rate was at 60% (44). As for low-and middle-income countries, vaccination was cost-saving from a societal perspective (10,48).…”

Economic evaluation of COVID-19 vaccination: A systematic review

“…The two remaining studies were conducted in multiple countries; the first one comprised four analyses from LMICs and two analyses from HICs [ 36 ], while the other study comprised 12 analyses in LMICs [ 42 ]. Sixteen studies were conducted in 2021 [ 21 - 28 , 30 - 33 , 35 - 37 , 41 ], while nine studies were conducted in 2022 [ 29 , 34 , 38 - 40 , 42 - 45 ]. Most of the included studies (21/25) aimed to estimating the economic evaluation of different vaccination strategies [ 21 - 30 , 32 , 33 , 35 - 38 , 40 , 42 - 45 ], while two studies were conducted with the goal of estimating the economic evaluation of vaccination vs no vaccination [ 34 , 41 ].…”

“…Sixteen studies were conducted in 2021 [ 21 - 28 , 30 - 33 , 35 - 37 , 41 ], while nine studies were conducted in 2022 [ 29 , 34 , 38 - 40 , 42 - 45 ]. Most of the included studies (21/25) aimed to estimating the economic evaluation of different vaccination strategies [ 21 - 30 , 32 , 33 , 35 - 38 , 40 , 42 - 45 ], while two studies were conducted with the goal of estimating the economic evaluation of vaccination vs no vaccination [ 34 , 41 ]. Only one study assessed the economic impact of booster vaccination [ 31 ], while another compared the intradermal vaccine with the intramuscular vaccine [ 39 ].…”

“…Only one study did not report the perspective adopted [ 39 ] ( Table 2 ). At least four studies specified a vaccination coverage of less than 50% [ 21 , 27 , 30 , 40 ], eight had a vaccination coverage of 50%-75% [ 22 , 26 , 34 - 37 , 44 , 45 ], and one specified a vaccination coverage of 100% [ 41 ]. Moreover, three studies presented a range of two to three categories of vaccination coverage each [ 25 , 32 , 42 ].…”

Cost-Effectiveness of COVID-19 Sequential Vaccination Strategies in Inactivated Vaccinated Individuals in China

“…A vast majority of countries have provided vaccinations to safeguard the population and economy throughout the pandemic. A regular vaccination strategy was proven to be cost-saving [ 2 , 3 , 4 ] and cost-effective [ 5 , 6 ] in both high-income countries (HICs) and in low- and middle-income countries (LMICs) [ 7 , 8 ]. However, with the variation in viruses across the globe and the waning vaccine effectiveness (VE) against viruses providing booster vaccination to fully vaccinated populations have been considered in many countries.…”