TY - JOUR
T1 - Cost-effectiveness analysis of BNT162b2 COVID-19 booster vaccination in the United States
AU - Li, Rui
AU - Liu, Hanting
AU - Fairley, Christopher K.
AU - Zou, Zhuoru
AU - Xie, Li
AU - Li, Xinghui
AU - Shen, Mingwang
AU - Li, Yan
AU - Zhang, Lei
N1 - Funding Information:
The work is supported by the Bill & Melinda Gates Foundation (INV-006104). LZ is supported by the National Natural Science Foundation of China (Grant number: 81950410639), Outstanding Young Scholars Funding (Grant number: 3111500001), Xi'an Jiaotong University Basic Research and Profession Grant (Grant number: xtr022019003 and xzy032020032), and Xi'an Jiaotong University Young Talent Support Grant (Grant number: YX6J004). MS was supported by the National Natural Science Foundation of China (Grant number: 12171387, 11801435), China Postdoctoral Science Foundation (Grant number: 2018M631134, 2020T130095ZX), the Fundamental Research Funds for the Central Universities (Grant number: xjh012019055), Natural Science Basic Research Program of Shaanxi Province (Grant number: 2019JQ-187), and Young Talent Support Program of Shaanxi University Association for Science and Technology (Grant number: 20210307). XL was supported by the Special emergency public health safety project of Shaanxi Provincial Education Department (Grant number: 20JG007).
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/6
Y1 - 2022/6
N2 - Objectives: To evaluate the cost-effectiveness of a booster strategy in the United States. Methods: We developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy of the Pfizer-BioNTech BNT162b2 (administered 6 months after the second dose) among older adults from a healthcare system perspective. Results: Compared with 2 doses of BNT162b2 without a booster, the booster strategy in a 100,000 cohort of older adults would incur an additional cost of $3.4 million in vaccination cost but save $6.7 million in direct medical cost and gain 3.7 quality-adjusted life-years in 180 days. This corresponds to a benefit-cost ratio of 1.95 and a net monetary benefit of $3.4 million. Probabilistic sensitivity analysis indicates that a booster strategy has a high chance (67%) of being cost-effective. Notably, the cost-effectiveness of the booster strategy is highly sensitive to the population incidence of COVID-19, with a cost-effectiveness threshold of 8.1/100,000 person-day. If vaccine efficacies reduce by 10%, 30%, and 50%, this threshold will increase to 9.7/100,000, 13.9/100,000, and 21.9/100,000 person-day, respectively. Conclusion: Offering the BNT162b2 booster to older adults aged ≥65 years in the United States is likely to be cost-effective. Less efficacious vaccines and boosters may still be cost-effective in settings of high SARS-CoV-2 transmission.
AB - Objectives: To evaluate the cost-effectiveness of a booster strategy in the United States. Methods: We developed a decision-analytic Markov model of COVID-19 to evaluate the cost-effectiveness of a booster strategy of the Pfizer-BioNTech BNT162b2 (administered 6 months after the second dose) among older adults from a healthcare system perspective. Results: Compared with 2 doses of BNT162b2 without a booster, the booster strategy in a 100,000 cohort of older adults would incur an additional cost of $3.4 million in vaccination cost but save $6.7 million in direct medical cost and gain 3.7 quality-adjusted life-years in 180 days. This corresponds to a benefit-cost ratio of 1.95 and a net monetary benefit of $3.4 million. Probabilistic sensitivity analysis indicates that a booster strategy has a high chance (67%) of being cost-effective. Notably, the cost-effectiveness of the booster strategy is highly sensitive to the population incidence of COVID-19, with a cost-effectiveness threshold of 8.1/100,000 person-day. If vaccine efficacies reduce by 10%, 30%, and 50%, this threshold will increase to 9.7/100,000, 13.9/100,000, and 21.9/100,000 person-day, respectively. Conclusion: Offering the BNT162b2 booster to older adults aged ≥65 years in the United States is likely to be cost-effective. Less efficacious vaccines and boosters may still be cost-effective in settings of high SARS-CoV-2 transmission.
KW - BNT162b2
KW - Booster
KW - Cost-effective analysis
KW - COVID-19
KW - Markov model
UR - https://www.scopus.com/pages/publications/85129386045
U2 - 10.1016/j.ijid.2022.03.029
DO - 10.1016/j.ijid.2022.03.029
M3 - Article
C2 - 35338008
AN - SCOPUS:85129386045
SN - 1201-9712
VL - 119
SP - 87
EP - 94
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -
SDG 3 Good Health and Well-being