Presentation (CTI)

OBJECTIVES: To evaluate the impact of incorporating 2025/2026 real-world evidence (RWE) of mRNA-1283 compared with BNT162b2 on previously projected public health and economic outcomes in the Netherlands.
METHODS: 2025/2026 data were used to update a published static Markov model evaluating the impacts of mRNA-1283 versus BNT162b2 among adults aged ≥60 years and 18-59 years (high-risk) in the Netherlands. Previously, mRNA-1283’s absolute vaccine effectiveness (aVE) was based on the NextCOVE trial and 2024/2025 mRNA-1273 effectiveness data from Veradigm's electronic health records (EHR) and linked administrative claims database, while aVE for BNT162b2 was derived using a published indirect treatment comparison (ITC). The current analysis included 2025/2026 estimates of mRNA-1283 aVE against medically-attended COVID-19 (51.2%; 95% CI: 47.0%-58.0%) and hospitalization (64.3%; 95% CI: 44.0%-77.9%) based on a matched cohort study of adults ≥65 years in Veradigm, with direct comparative vaccine effectiveness (cVE) estimates versus BNT162b2 from a matched cohort study of adults aged ≥65 years in the U.S. Veterans Health Administration database (35.9% [95% CI: 20.4%-50.9%) against medically-attended COVID-19; 47.0% [95% CI: 2.5%-75.6%] against hospitalization). Health outcomes, healthcare costs, quality-adjusted life-years (QALYs), and the incremental economically justifiable price (EJP) were estimated over one year.
RESULTS: Compared with BNT162b2, mRNA-1283 may prevent an additional 37,136 symptomatic infections, 2,540 hospitalizations, and 572 deaths, resulting in €32.6 million in cost-savings and 4,613 QALYs gained. At a willingness-to-pay threshold of €50,000/QALY, the EJP of mRNA-1283 versus BNT162b2 was €108.43. Results were robust across alternate incidence scenarios.
CONCLUSIONS: These findings suggest that mRNA-1283 may provide greater clinical and economic benefits than previously estimated, in comparison with BNT162b2, for the Netherlands.