ECONOMIC EVALUATION OF EMERGENCY USE AUTHORISED COVID 19 VACCINES INDIA - A MODEL BASED COST UTILITY ANALYSIS
Author(s)
Shubhanjali Roy, BDS, MSC_CR1, Alveena Malik, BDS, MPH2, Alka Singh3, Nirupama Adhikari, MPH4, Rashmi Das, BDS, MPH5, Sarit Rout, PhD6, Ranjana Singh, MPS, MPH, PhD6, Shomik Ray, MPH, MPhil7.
1Public Health Foundation of India, NEW DELHI, India, 2Indian Institute of Public Health Delhi, New Delhi, India, 3Indian Institute of Public Health - Delhi, India, 4Indian Institute of Public Health Bhubaneshwar, Bhubaneshwar, India, 5Public Health Foundation of India, Bhubaneshwar, India, 6Public Health Foundation of India, New Delhi, India, 7Professor, Public Health Practice, Indian Institute of Public Health - Delhi, New Delhi, India.
1Public Health Foundation of India, NEW DELHI, India, 2Indian Institute of Public Health Delhi, New Delhi, India, 3Indian Institute of Public Health - Delhi, India, 4Indian Institute of Public Health Bhubaneshwar, Bhubaneshwar, India, 5Public Health Foundation of India, Bhubaneshwar, India, 6Public Health Foundation of India, New Delhi, India, 7Professor, Public Health Practice, Indian Institute of Public Health - Delhi, New Delhi, India.
OBJECTIVES: India granted Emergency Use Authorisation (EUA) to multiple COVID-19 vaccines delivered through public and private channels. This study assessed the comparative cost-utility of key EUA vaccines in India.
METHODS: A retrospective, decision analytical model-based economic evaluation was conducted using an abridged societal perspective (financial costs only) with a 1-year analytic horizon. Primary data on vaccination and COVID-19 illness costs and care pathways were collected from adults (≥18 years) in Delhi and Bhubaneswar (500 households, multistage sampling). A decision-analytic model captured dose completion (1/2/3 doses), vaccination, treatment setting (government/private), and treatment type (allopathic/AYUSH/both). Health outcomes were expressed as QALYs derived from EQ-5D-5L using the India-specific value set. ICERs compared to no vaccination were estimated; one-way sensitivity analysis and probabilistic sensitivity analysis using 10,000 Monte Carlo simulations were performed. A willingness-to-pay threshold of ₹200,000/QALY was applied, and EVPI was estimated.
RESULTS: Base-case QALYs were estimated at 0.9971 (Covaxin), 0.9943 (Covishield), 0.9968 (Sputnik-V), and 0.9876 (no vaccination). Total costs per individual were ₹961.72, ₹1,042.19, and ₹3,468.37 for Covaxin, Covishield, and Sputnik-V, respectively. ICERs were ₹86,987.68/QALY (Covaxin), ₹135,013.86/QALY (Covishield), and ₹360,042.30/QALY (Sputnik-V). Both Covaxin and Covishield was found to be cost effective at the threshold of ₹200,000 with Covaxin being more cost effective. Sputnik was found to be not cost effective. At ₹200,000/QALY, PSA showed the highest probability of cost-effectiveness for Covaxin (66.7%), followed by Covishield (31.0%) and Sputnik-V (1.98%). EVPI was ₹1,088.04/person, driven mainly by uncertainty in coverage probabilities.
CONCLUSIONS: Covaxin was the most cost-effective EUA vaccine strategy, with Covishield also being cost-effective; Sputnik-V was found to be the least efficient due to high costs.
METHODS: A retrospective, decision analytical model-based economic evaluation was conducted using an abridged societal perspective (financial costs only) with a 1-year analytic horizon. Primary data on vaccination and COVID-19 illness costs and care pathways were collected from adults (≥18 years) in Delhi and Bhubaneswar (500 households, multistage sampling). A decision-analytic model captured dose completion (1/2/3 doses), vaccination, treatment setting (government/private), and treatment type (allopathic/AYUSH/both). Health outcomes were expressed as QALYs derived from EQ-5D-5L using the India-specific value set. ICERs compared to no vaccination were estimated; one-way sensitivity analysis and probabilistic sensitivity analysis using 10,000 Monte Carlo simulations were performed. A willingness-to-pay threshold of ₹200,000/QALY was applied, and EVPI was estimated.
RESULTS: Base-case QALYs were estimated at 0.9971 (Covaxin), 0.9943 (Covishield), 0.9968 (Sputnik-V), and 0.9876 (no vaccination). Total costs per individual were ₹961.72, ₹1,042.19, and ₹3,468.37 for Covaxin, Covishield, and Sputnik-V, respectively. ICERs were ₹86,987.68/QALY (Covaxin), ₹135,013.86/QALY (Covishield), and ₹360,042.30/QALY (Sputnik-V). Both Covaxin and Covishield was found to be cost effective at the threshold of ₹200,000 with Covaxin being more cost effective. Sputnik was found to be not cost effective. At ₹200,000/QALY, PSA showed the highest probability of cost-effectiveness for Covaxin (66.7%), followed by Covishield (31.0%) and Sputnik-V (1.98%). EVPI was ₹1,088.04/person, driven mainly by uncertainty in coverage probabilities.
CONCLUSIONS: Covaxin was the most cost-effective EUA vaccine strategy, with Covishield also being cost-effective; Sputnik-V was found to be the least efficient due to high costs.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE71
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), STA: Vaccines