Modeling the Potential Public Health Impact and Cost-Effectiveness of BNT162b2 COVID-19 Adapted Booster Vaccination in Dominican Republic
Moderator
Juan José Baldi-Castro, MSc, PharmD, Pfizer Inc., Escazú, Costa Rica
Speakers
Carlos Fernando Mendoza; Iustina Chirila, MSc; Moe Hein Kyaw; Elena Aruffo; Ben Yarnoff; Leo Alejandro Barrantes; Karen Villamil; Marcel Marcano-Lozada
OBJECTIVES: This study evaluated the public health impact and cost-effectiveness of a booster strategy with BNT162b2 COVID-19 vaccine, considering both the national healthcare system and societal perspectives in Dominican Republic (DR).
METHODS: A combined Markov-decision tree model was used to estimate the economic and public health impact of vaccination strategies targeting various age groups in over a one-year time horizon, considering an adjusted eligible population of individuals ≥65 years and high-risk population aged 18-64 years (n=1,157,891) as part of the base-case. Age-stratified annual attack rates of cases, hospitalizations, and deaths, and vaccine coverage rates were informed by the literature and local surveillance and Ministry of Health data for the Omicron period. Other age-stratified clinical, cost, and vaccine effectiveness parameters were informed by local and international sources and the literature. Costs were presented in US$ (2024). Multiple sensitivity and scenario analysis were conducted to assess the robustness and uncertainty of the findings.
RESULTS: Comparted to no vaccination, a BNT162b2 COVID-19 vaccination strategy targeting individuals aged ≥65 years and the high-risk population aged 18-64 years (with 246,728 doses administered) was estimated to avert 8,101 symptomatic cases, 2 deaths, 76 hospitalizations, and 208 lost quality-adjusted life years (QALYs). Direct medical costs decreased by US$9.6 million and total societal costs decreased by US$11.2 million. Vaccination was cost-saving (dominant) from both the payer and societal perspectives. Targeting vaccination for those aged ≥60 years and high-risk adults aged 18-64 was more effective in preventing cases, hospitalizations, and QALYs loss, while also saving costs.
CONCLUSIONS: Prioritizing vaccination for individuals aged 65 and older, as well as high-risk individuals aged 18-64 in the DR, provides substantial public health and economic benefits annually. Implementing vaccination strategies that encompass a wider age range could serve as a significant public health initiative and offer potential cost savings.
METHODS: A combined Markov-decision tree model was used to estimate the economic and public health impact of vaccination strategies targeting various age groups in over a one-year time horizon, considering an adjusted eligible population of individuals ≥65 years and high-risk population aged 18-64 years (n=1,157,891) as part of the base-case. Age-stratified annual attack rates of cases, hospitalizations, and deaths, and vaccine coverage rates were informed by the literature and local surveillance and Ministry of Health data for the Omicron period. Other age-stratified clinical, cost, and vaccine effectiveness parameters were informed by local and international sources and the literature. Costs were presented in US$ (2024). Multiple sensitivity and scenario analysis were conducted to assess the robustness and uncertainty of the findings.
RESULTS: Comparted to no vaccination, a BNT162b2 COVID-19 vaccination strategy targeting individuals aged ≥65 years and the high-risk population aged 18-64 years (with 246,728 doses administered) was estimated to avert 8,101 symptomatic cases, 2 deaths, 76 hospitalizations, and 208 lost quality-adjusted life years (QALYs). Direct medical costs decreased by US$9.6 million and total societal costs decreased by US$11.2 million. Vaccination was cost-saving (dominant) from both the payer and societal perspectives. Targeting vaccination for those aged ≥60 years and high-risk adults aged 18-64 was more effective in preventing cases, hospitalizations, and QALYs loss, while also saving costs.
CONCLUSIONS: Prioritizing vaccination for individuals aged 65 and older, as well as high-risk individuals aged 18-64 in the DR, provides substantial public health and economic benefits annually. Implementing vaccination strategies that encompass a wider age range could serve as a significant public health initiative and offer potential cost savings.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE52
Topic
Economic Evaluation
Disease
STA: Vaccines