ECONOMIC BREAK-EVEN OF CAPACITY-RESERVATION MODELS FOR ANTIVIRAL PANDEMIC PREPAREDNESS IN GERMANY
Author(s)
York Francis Zoellner, PhD1, Till Schickle, MSc2, Svenja Schwarz, MSc2, Mike Raddatz, MSc2, Jan Witte, MD3, Mario Menk, MD4.
1Hamburg University of Applied Sciences, Hamburg, Germany, 2Institute for Policy Evaluation, Frankfurt am Main, Germany, 3Shionogi GmbH, Berlin, Germany, 4Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany.
1Hamburg University of Applied Sciences, Hamburg, Germany, 2Institute for Policy Evaluation, Frankfurt am Main, Germany, 3Shionogi GmbH, Berlin, Germany, 4Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany.
OBJECTIVES: Reactive pandemic procurement can defer expenditure until a crisis but may leave decision makers without timely antiviral access. This analysis quantified the economic break-even and return-on-investment (ROI) profile of a pre-arranged antiviral capacity-reservation model in Germany by estimating when cumulative net savings offset preparedness expenditure and how return-on-investment compared with a physical stockpile benchmark.
METHODS: A break-even and return-on-investment analysis was conducted using a German societal-perspective preparedness model calibrated to the first COVID-19 pandemic year. A 10-year pre-pandemic horizon was linked to a one-year respiratory pandemic scenario. Capacity reservation, defined by annual readiness payments and pandemic-period call-off, was assessed against reactive procurement as the no-preparedness reference and a physical stockpile as an active preparedness benchmark. Cumulative net savings were calculated as avoided pandemic-period direct healthcare and indirect productivity costs minus discounted preparedness expenditure. Primary outcomes were break-even month, net savings versus reactive procurement, and ROI. One-way sensitivity analyses varied stockpile quantity, delivery shortfall risk, antiviral effectiveness, and preparedness duration.
RESULTS: Discounted preparedness expenditure over 10 years was lower with capacity reservation than with a physical stockpile (€0.8 billion vs. €2.4 billion). Capacity reservation generated higher cumulative net savings versus reactive procurement than the physical stockpile (€6.8 billion vs. €6.1 billion). Economic break-even was reached within the first pandemic month, approximately six months earlier than with the physical stockpile. ROI was higher for capacity reservation than for the physical stockpile (8.3 vs. 2.6). Net savings remained positive across all tested one-way sensitivity ranges; stockpile quantity was the strongest driver.
CONCLUSIONS: In this model-based German analysis, antiviral capacity reservation showed earlier economic payback and higher ROI than physical stockpiling. For policymakers, these findings suggest that pre-arranged access mechanisms may help reduce fiscal inefficiency associated with expiry-prone inventory replacement, while maintaining equivalent preparedness levels.
METHODS: A break-even and return-on-investment analysis was conducted using a German societal-perspective preparedness model calibrated to the first COVID-19 pandemic year. A 10-year pre-pandemic horizon was linked to a one-year respiratory pandemic scenario. Capacity reservation, defined by annual readiness payments and pandemic-period call-off, was assessed against reactive procurement as the no-preparedness reference and a physical stockpile as an active preparedness benchmark. Cumulative net savings were calculated as avoided pandemic-period direct healthcare and indirect productivity costs minus discounted preparedness expenditure. Primary outcomes were break-even month, net savings versus reactive procurement, and ROI. One-way sensitivity analyses varied stockpile quantity, delivery shortfall risk, antiviral effectiveness, and preparedness duration.
RESULTS: Discounted preparedness expenditure over 10 years was lower with capacity reservation than with a physical stockpile (€0.8 billion vs. €2.4 billion). Capacity reservation generated higher cumulative net savings versus reactive procurement than the physical stockpile (€6.8 billion vs. €6.1 billion). Economic break-even was reached within the first pandemic month, approximately six months earlier than with the physical stockpile. ROI was higher for capacity reservation than for the physical stockpile (8.3 vs. 2.6). Net savings remained positive across all tested one-way sensitivity ranges; stockpile quantity was the strongest driver.
CONCLUSIONS: In this model-based German analysis, antiviral capacity reservation showed earlier economic payback and higher ROI than physical stockpiling. For policymakers, these findings suggest that pre-arranged access mechanisms may help reduce fiscal inefficiency associated with expiry-prone inventory replacement, while maintaining equivalent preparedness levels.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE42
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas