Modeling the Potential Public Health Impact and Cost-Effectiveness of BNT162b2 COVID-19 Adapted Booster Vaccination in Guatemala
Author(s)
Juan José Baldi-Castro, MSc, PharmD1, Carlos Fernando 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 Inc., 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., Global Scientific Affairs, COVID-19 & Flu, Collegeville, PA, USA, 5Evidera Inc., Modelling & Simulation, Washington, WA, USA, 6Pfizer Central America & Caribbean, Value & Evidence Coordinator, Escazú, Costa Rica, 7Pfizer Central America & Caribbean, Vaccines Medical Manage, Escazú, Costa Rica, 8Pfizer Central America & Caribbean, Internal Medicine & Vaccines Medical Lead, Escazú, Costa Rica
1Pfizer Inc., 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., Global Scientific Affairs, COVID-19 & Flu, Collegeville, PA, USA, 5Evidera Inc., Modelling & Simulation, Washington, WA, USA, 6Pfizer Central America & Caribbean, Value & Evidence Coordinator, Escazú, Costa Rica, 7Pfizer Central America & Caribbean, Vaccines Medical Manage, Escazú, Costa Rica, 8Pfizer Central America & Caribbean, Internal Medicine & Vaccines Medical Lead, Escazú, Costa Rica
Presentation Documents
OBJECTIVES: This study evaluated the public health impact and cost-effectiveness of a booster strategy with BNT162b2 COVID-19 vaccine from both the national public healthcare system and societal perspectives in Guatemala.
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=1,240,482) 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 analyses were performed to evaluate 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 154,759 doses administered) was estimated to avert 10,883 symptomatic cases, 3 deaths, 100 hospitalizations, and 286 lost quality-adjusted life years (QALYs). Direct medical costs decreased by US$7.8 million and total societal costs decreased by US$8.7 million. Vaccination was cost-saving (dominant) from both the payer and societal perspectives. A vaccination strategy focusing on individuals ≥60 years, as well as high-risk individuals aged 18-64 years, was estimated to prevent more cases, hospitalizations, and loss of QALYs, while also saving costs.
CONCLUSIONS: Adopting a vaccination strategy that prioritizes individuals aged 65 and older, along with those aged 18-64 who are at high risk, yields substantial public health and economic benefits on an annual basis. Expanding vaccination strategies to include a broader age range may constitute an important public health measure and provide potential cost savings.
METHODS: A combined Markov-decision tree model was used to estimate the economic and public health impact of vaccination strategies targeting various age groups over a one-year time horizon, considering an adjusted eligible population of individuals ≥65 years and high-risk population aged 18-64 years (n=1,240,482) as part of the base-case. Age-stratified annual attack rates of cases, hospitalizations, and deaths, and vaccine coverage rates were informed by the literature and local surveillance and Ministry of Health data for the Omicron period. Other age-stratified clinical, cost, and vaccine effectiveness parameters were informed by local and international sources and the literature. Costs were presented in US$ (2024). Various sensitivity and scenario analyses were performed to evaluate 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 154,759 doses administered) was estimated to avert 10,883 symptomatic cases, 3 deaths, 100 hospitalizations, and 286 lost quality-adjusted life years (QALYs). Direct medical costs decreased by US$7.8 million and total societal costs decreased by US$8.7 million. Vaccination was cost-saving (dominant) from both the payer and societal perspectives. A vaccination strategy focusing on individuals ≥60 years, as well as high-risk individuals aged 18-64 years, was estimated to prevent more cases, hospitalizations, and loss of QALYs, while also saving costs.
CONCLUSIONS: Adopting a vaccination strategy that prioritizes individuals aged 65 and older, along with those aged 18-64 who are at high risk, yields substantial public health and economic benefits on an annual basis. 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
EE474
Topic
Economic Evaluation
Disease
STA: Vaccines