OBJECTIVES:

The objective of this study was to estimate the cost-effective price of a SARS-COV-2 vaccine in the French context.

METHODS: A decision tree model was developed to compare two alternative strategies, vaccination and lockdown, to prevent a potential new COVID-19 wave with an impact assumed similar to that observed over March to June 2020 in France. The model considered hospitalisations, intensive care unit (ICU) admissions and deaths associated with COVID-19, and resulting life-years lost, QALYs lost and costs from the French public payer (PP) and societal perspective. The burden of disease with vaccination was assumed to be reduced by 80% compared to the lockdown strategy. Indirect costs included a GDP reduction of 5.2% primarily attributable to the lockdown in scenario without vaccination.

The maximum price per person vaccinated leading to incremental costs per QALY gained below cost-effectiveness thresholds of €50,000 and €25,000 from the PP and societal perspectives respectively were estimated.

RESULTS: The vaccination strategy would avoid about 37 deaths, 140 hospitalisations, 23 ICU admissions and save €890,000 in hospitalisation and ICU costs per 100,000 people, compared to lockdown. 301 LYs and 223 discounted QALYs lost would be avoided per 100,000 people. Indirect costs of €235 million would be saved per 100,000 people, assuming the economy functions normally in the scenario with vaccination

The maximum cost-effective price of the vaccine was assessed at 134€ in the PP perspective and 2,684€ from the societal point of view.

CONCLUSIONS: Compared to the lockdown, the vaccination strategy would avoid substantial productivity costs. The “cost-effective” price from PP perspective is unlikely to represent the value attached by individuals and authorities to a COVID-19 vaccine, and may not provide a sufficient incentive for industry to develop a vaccine. . Considering a societal perspective, and a new cost-effectiveness threshold would be more relevant.