Modeling the Potential Public Health Impact and Cost-Effectiveness of BNT162b2 COVID-19 Adapted Booster Vaccination in Costa Rica
Author(s)
Juan José Baldi-Castro, MSc, PharmD1, Carlos F. Mendoza, PharmD, MSc, PhD2, Iustina Chirila, MSc3, Moe Hein Kyaw, PhD4, Elena Aruffo, PhD5, Ben Yarnoff, PhD5, Leo Alejandro Barrantes, PharmD6, Karen Villamil, MD7, Marcel Marcano-Lozada, MD, FASM8;
1Pfizer Central America & Caribbean, HEOR Strategy Lead, Central America and the Caribbean, Escazú, Costa Rica, 2Pfizer Inc., Global HV&E mRNA Vaccines, CDMX, Mexico, 3Pfizer Ltd, Global HV&E mRNA Vaccines, Tadworth, United Kingdom, 4Pfizer Inc, Pfizer Inc, PA, PA, USA, 5Evidera Inc, Modelling & Simulation, Bethesda, WA, USA, 6Pfizer Central America & Caribbean, Value & Evidence Coordinator, Escazú, Costa Rica, 7Pfizer Central America & Caribbean, Vaccines Medical Manager, Escazú, Costa Rica, 8Pfizer Central America & Caribbean, Internal Medicine & Vaccines Medical Lead, Escazú, Costa Rica
1Pfizer Central America & Caribbean, HEOR Strategy Lead, Central America and the Caribbean, Escazú, Costa Rica, 2Pfizer Inc., Global HV&E mRNA Vaccines, CDMX, Mexico, 3Pfizer Ltd, Global HV&E mRNA Vaccines, Tadworth, United Kingdom, 4Pfizer Inc, Pfizer Inc, PA, PA, USA, 5Evidera Inc, Modelling & Simulation, Bethesda, WA, USA, 6Pfizer Central America & Caribbean, Value & Evidence Coordinator, Escazú, Costa Rica, 7Pfizer Central America & Caribbean, Vaccines Medical Manager, Escazú, Costa Rica, 8Pfizer Central America & Caribbean, Internal Medicine & Vaccines Medical Lead, Escazú, Costa Rica
Presentation Documents
OBJECTIVES: This study assessed the public health impact and cost-effectiveness of a booster strategy with BNT162b2 COVID-19 vaccine, considering both the national public healthcare system and societal perspectives in Costa Rica.
METHODS: A combined Markov-decision tree model was used to estimate the economic and public health impact of vaccination strategies targeting various age groups over a one-year time horizon, considering an adjusted eligible population of individuals ≥65 years and high-risk population aged 18-64 years (n=794,546) 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). Various sensitivity and scenario analysis were conducted to assess the robustness and uncertainty of the findings.
RESULTS: Compared to no vaccination, a BNT162b2 COVID-19 vaccination strategy targeting individuals aged ≥65 years and the high-risk population aged 18-64 years (with 114,350 doses administered) was estimated to avert 3,224 symptomatic cases, 1 death, 29 hospitalizations, and 85 lost quality-adjusted life years (QALYs). Direct medical costs decreased by US$8.2 million and total societal costs decreased by US$9.2 million. Vaccination was cost-saving (dominant) from both the payer and societal perspectives. A vaccination strategy targeting individuals aged ≥60 years and the high-risk population aged 18-64 years was estimated to avert even more cases, hospitalizations, and loss of QALYs, while also being cost saving.
CONCLUSIONS: Implementing a vaccination strategy that prioritizes individuals aged ≥65, as well as those aged 18-64 years at high risk, results in significant public health and economic benefits annually. Expanding vaccination strategies to include a broader age range may constitute an important public health measure and provide potential cost savings.
METHODS: A combined Markov-decision tree model was used to estimate the economic and public health impact of vaccination strategies targeting various age groups over a one-year time horizon, considering an adjusted eligible population of individuals ≥65 years and high-risk population aged 18-64 years (n=794,546) as part of the base-case. Age-stratified annual attack rates of cases, hospitalizations, and deaths, and vaccine coverage rates were informed by the literature and local surveillance and Ministry of Health data for the Omicron period. Other age-stratified clinical, cost, and vaccine effectiveness parameters were informed by local and international sources and the literature. Costs were presented in US$ (2024). Various sensitivity and scenario analysis were conducted to assess the robustness and uncertainty of the findings.
RESULTS: Compared to no vaccination, a BNT162b2 COVID-19 vaccination strategy targeting individuals aged ≥65 years and the high-risk population aged 18-64 years (with 114,350 doses administered) was estimated to avert 3,224 symptomatic cases, 1 death, 29 hospitalizations, and 85 lost quality-adjusted life years (QALYs). Direct medical costs decreased by US$8.2 million and total societal costs decreased by US$9.2 million. Vaccination was cost-saving (dominant) from both the payer and societal perspectives. A vaccination strategy targeting individuals aged ≥60 years and the high-risk population aged 18-64 years was estimated to avert even more cases, hospitalizations, and loss of QALYs, while also being cost saving.
CONCLUSIONS: Implementing a vaccination strategy that prioritizes individuals aged ≥65, as well as those aged 18-64 years at high risk, results in significant public health and economic benefits annually. Expanding vaccination strategies to include a broader age range may constitute an important public health measure and provide potential cost savings.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE156
Topic
Economic Evaluation
Disease
STA: Vaccines