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The Potential Public Health and Economic Value of a Hypothetical COVID-19 Vaccine in the United States: Use of Cost-Effectiveness Modeling to Inform Vaccination Prioritization

47 Pages Posted: 25 Sep 2020

See all articles by Michele Kohli

Michele Kohli

Quadrant Health Economics Inc

Michael Maschio

Quadrant Health Economics Inc

Debbie Becker

Quadrant Health Economics Inc

Milton Weinstein

Harvard University

More...

Abstract

Background: Researchers are working at unprecedented speed to develop a SARS-CoV-2 vaccine. We aimed to assess the value of a hypothetical vaccine and its potential public health impact when prioritization is required due to supply constraints.

Methods: A Markov cohort model was used to compare COVID-19 related direct medical costs and deaths in the United States (US), with versus without implementation of a 60% efficacious vaccine. To prioritize the vaccine under constrained supply, the population was divided into tiers based on age; risk and age; and occupation and age; and outcomes were compared across one year under various supply assumptions. For each prioritization strategy, the incremental cost per quality-adjusted life-year (QALY) gained versus no vaccine was calculated overall and by tier.

Findings: Overall, the cost per QALY gained for all vaccination strategies was $8,200 versus no vaccination. For the tiers at highest risk of complications from COVID-19, vaccination was cost-saving compared to no vaccination. The cost per QALY gained increased as the risk of hospitalization and death within each tier decreased. Under the most optimistic supply scenario and the most efficient prioritization scenario, the vaccine may prevent 32% of expected deaths. As supply becomes more constrained, prioritization is required to optimize the prevention of deaths.

Interpretation: A COVID-19 vaccine is predicted to be good value for money (cost per QALY gained <$50,000). The speed at which an effective vaccine can be made available will determine how much morbidity and mortality may be prevented in the US.

Funding: Moderna, Inc.

Declaration of Interests: MK and DB are shareholders in Quadrant Health Economics Inc. Quadrant Health Economics Inc. was contracted by Moderna, Inc. to conduct this study. MM and MCW are consultants at Quadrant Health Economics Inc.

Keywords: Coronavirus, COVID-19, cost-effectiveness analysis, economic analysis, SARS-CoV-2, vaccine

Suggested Citation

Kohli, Michele and Maschio, Michael and Becker, Debbie and Weinstein, Milton, The Potential Public Health and Economic Value of a Hypothetical COVID-19 Vaccine in the United States: Use of Cost-Effectiveness Modeling to Inform Vaccination Prioritization. Available at SSRN: https://ssrn.com/abstract=3684475 or http://dx.doi.org/10.2139/ssrn.3684475

Michele Kohli (Contact Author)

Quadrant Health Economics Inc ( email )

92 Cottonwood Crescent
Cambridge, MA
United States

Michael Maschio

Quadrant Health Economics Inc ( email )

Debbie Becker

Quadrant Health Economics Inc ( email )

Milton Weinstein

Harvard University ( email )

1875 Cambridge Street
Cambridge, MA 02138
United States

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