Dataset Information

Cost-Effectiveness Analysis of Strategies of COVID-19 Vaccination in Colombia: Comparison of High-Risk Prioritization and No Prioritization Strategies With the Absence of a Vaccination Plan.

ABSTRACT:

Objectives

Our study compares two national COVID-19 vaccination plan strategies-high-risk prioritization and no prioritization-and estimates their cost-effectiveness compared with no vaccination, to generate possible recommendations for future vaccination plans.

Methods

We developed a Markov discrete-time, compartmental, deterministic model stratified by Colombian departments, healthcare workers, comorbidities, and age groups and calibrated to seroprevalence, cases, and deaths. The model simulates three scenarios: no vaccination, no prioritization of vaccination, and prioritization of high-risk population. The study presents the perspective of the health system of Colombia, including the direct health costs financed by the government and the direct health outcomes related to the infection. We measured symptomatic cases, deaths, and costs for each of the three scenarios from the start of the vaccination rollout to February 20, 2023.

Results

Both for the base-case and across multiple sensitivity analyses, the high-risk prioritization proves to be the most cost-effective of the considered strategies. An increment of US$255 million results in an incremental cost-effectiveness ratio of US$3339 per disability-adjusted life-year avoided. The simulations show that prioritization of high-risk population reduces symptomatic cases by 3.4% and deaths by 20.1% compared with no vaccination. The no-prioritization strategy is still cost-effective, with an incremental cost-effectiveness ratio of US$5223.66, but the sensitivity analysis the show potential risks of losing cost-effectiveness under the cost-effectiveness threshold (one gross domestic product per averted disability-adjusted life-year).

Conclusions

The high-risk prioritization strategy is consistently more cost-effective than the no-prioritization strategy across multiple scenarios. High-risk prioritization is the recommended strategy in low-resource settings to reduce the burden of disease.

SUBMITTER: Morales-Zamora G

PROVIDER: S-EPMC9132610 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

Cost-Effectiveness Analysis of Strategies of COVID-19 Vaccination in Colombia: Comparison of High-Risk Prioritization and No Prioritization Strategies With the Absence of a Vaccination Plan.

Morales-Zamora Gilberto G Espinosa Oscar O Puertas Edwin E Fernández Juan Carlos JC Hernández José J Zakzuk Verónica V Cepeda Magda M Alvis-Gúzman Nelson N Castañeda-Orjuela Carlos C Paternina-Caicedo Angel A

Value in health regional issues 20220526

<h4>Objectives</h4>Our study compares two national COVID-19 vaccination plan strategies-high-risk prioritization and no prioritization-and estimates their cost-effectiveness compared with no vaccination, to generate possible recommendations for future vaccination plans.<h4>Methods</h4>We developed a Markov discrete-time, compartmental, deterministic model stratified by Colombian departments, healthcare workers, comorbidities, and age groups and calibrated to seroprevalence, cases, and deaths. Th ...[more]

PMID: 35640462

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Project description:BackgroundA critical issue in planning pandemic influenza mitigation strategies is the delay between the arrival of the pandemic in a community and the availability of an effective vaccine. The likely scenario, born out in the 2009 pandemic, is that a newly emerged influenza pandemic will have spread to most parts of the world before a vaccine matched to the pandemic strain is produced. For a severe pandemic, additional rapidly activated intervention measures will be required if high mortality rates are to be avoided.MethodsA simulation modelling study was conducted to examine the effectiveness and cost effectiveness of plausible combinations of social distancing, antiviral and vaccination interventions, assuming a delay of 6-months between arrival of an influenza pandemic and first availability of a vaccine. Three different pandemic scenarios were examined; mild, moderate and extreme, based on estimates of transmissibility and pathogenicity of the 2009, 1957 and 1918 influenza pandemics respectively. A range of different durations of social distancing were examined, and the sensitivity of the results to variation in the vaccination delay, ranging from 2 to 6 months, was analysed.ResultsVaccination-only strategies were not cost effective for any pandemic scenario, saving few lives and incurring substantial vaccination costs. Vaccination coupled with long duration social distancing, antiviral treatment and antiviral prophylaxis was cost effective for moderate pandemics and extreme pandemics, where it saved lives while simultaneously reducing the total pandemic cost. Combined social distancing and antiviral interventions without vaccination were significantly less effective, since without vaccination a resurgence in case numbers occurred as soon as social distancing interventions were relaxed. When social distancing interventions were continued until at least the start of the vaccination campaign, attack rates and total costs were significantly lower, and increased rates of vaccination further improved effectiveness and cost effectiveness.ConclusionsThe effectiveness and cost effectiveness consequences of the time-critical interplay of pandemic dynamics, vaccine availability and intervention timing has been quantified. For moderate and extreme pandemics, vaccination combined with rapidly activated antiviral and social distancing interventions of sufficient duration is cost effective from the perspective of life years saved.

Project description:IntroductionSince September 2020, Chinese populations aged > 3 years have been encouraged to receive a two-dose inoculation with vaccines against coronavirus disease 2019 (COVID-19). This study aims to evaluate the cost-effectiveness of the current vaccination strategy amongst the general population in mainland China from a societal perspective.MethodsIn this study, we construct a decision tree with Markov models to compare the economic and health consequences of the current vaccination strategy versus a no-vaccination scenario, over a time horizon of one year and an annual discount rate of 5%. Transition probabilities, health utilities, healthcare costs, and productivity losses are estimated from literature. Outcome measures include infection rates, death rates, quality-adjusted life years (QALYs), and costs. The incremental cost-effectiveness ratio (ICER) is then calculated to evaluate the cost-effectiveness of the current vaccination strategy, and both one-way deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA) are applied to assess the impact of uncertainties on results.ResultsOur simulation indicates that compared with a no-vaccination scenario, vaccination amongst the general population in mainland China would reduce the infection rate from 100% to 45.3% and decrease the death rate from 6.8% to 3.1%. Consequently, the strategy will lead to a saving of 37,664.77 CNY (US$5,256.70) and a gain of 0.50 QALYs per person per year on average (lifetime QALY and productivity loss due to immature death are included). The cost-saving for each QALY gain is 74,895.69 CNY (US$10,452.85). Result of the PSA indicates that vaccination is the dominating strategy with a probability of 97.9%, and the strategy is cost-effective with a probability of 98.5% when the willingness-to-pay (WTP) is 72,000 CNY (US$10,048.71) per QALY.ConclusionCompared with a no-vaccination scenario, vaccination among the general population in mainland China is the dominating strategy from a societal perspective. The conclusion is considered robust in the sensitivity analyses.

Dataset Information

Cost-Effectiveness Analysis of Strategies of COVID-19 Vaccination in Colombia: Comparison of High-Risk Prioritization and No Prioritization Strategies With the Absence of a Vaccination Plan.

Objectives

Methods

Results

Conclusions

Publications

Cost-Effectiveness Analysis of Strategies of COVID-19 Vaccination in Colombia: Comparison of High-Risk Prioritization and No Prioritization Strategies With the Absence of a Vaccination Plan.

Similar Datasets

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