Assessing the potential impact of COVID-19 booster doses and oral antivirals: A mathematical modelling study of selected middle-income countries in the Indo-Pacific

Bilgin, Gizem M.; Lokuge, Kamalini; Munira, Syarifah Liza; Glass, Kathryn

doi:10.1016/j.jvacx.2023.100386

Cited by 2 publications

(3 citation statements)

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“…Our comparator for this analysis was the continuation of existing primary and booster vaccine programs without oral antivirals and without further booster doses. The epidemiological impacts of COVID-19 booster doses and oral antivirals were quantified in a previous mathematical modelling paper [6]. Here, we estimate the cost of administering COVID-19 booster doses, the cost of delivering oral COVID-19 antivirals, and the costs averted by either intervention.…”

Section: Methodsmentioning

confidence: 99%

“…The details of the deterministic COVID-19 transmission model and stochastic severe outcome projections have been described in previous papers [6, 11], and a summary is provided in S1 Underlying Dynamic Transmission Model. In brief, we constructed a Susceptible-Exposed-Infected-Recovered (SEIR) model stratified by age, comorbidities, and vaccination status.…”

Section: Methodsmentioning

confidence: 99%

“…In a previous paper, we constructed a dynamic transmission model to estimate the impact of oral antivirals and booster doses on the burden of disease in Fiji, Indonesia, Timor-Leste, and Papua New Guinea – four middle-income nations with varying vaccine coverage, vaccine hesitancy, prevalence of comorbidities, and age structure. The model found that booster doses had the largest population-level impact in settings with high vaccine acceptance, and oral antivirals had the largest population-level impact in settings with lower vaccine acceptance [6]. This modelling provided evidence for the continued provision of booster doses to high-risk adults, and increased access to oral antivirals in low- and middle-income settings.…”

Section: Introductionmentioning

confidence: 98%

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Cost-effectiveness analysis of COVID-19 booster doses and oral antivirals in the Indo-Pacific

Bilgin,

Munira,

Lokuge

et al. 2023

Preprint

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Background: Decision-makers in middle-income countries need evidence on the cost-effectiveness of COVID-19 booster doses and oral antivirals to appropriately prioritise these healthcare interventions. Methods: We used a dynamic transmission model to assess the cost-effectiveness of COVID-19 booster doses and oral antivirals in Fiji, Indonesia, Papua New Guinea, and Timor-Leste. We conducted cost-effectiveness analysis from both healthcare and societal perspectives using 3% discounting for ongoing costs and health benefits. We developed an interactive R Shiny which allows the user to vary key model assumptions, such as the choice of discounting rate, and view how these assumptions affect model results. Findings: Booster doses were cost saving and therefore cost-effective in all four middle-income settings from both healthcare and societal perspectives using 3% discounting. Providing oral antivirals was cost-effective from a healthcare perspective if procured at a low generic ($25 United States Dollars) or middle-income reference price ($250 United States Dollars); however, their cost-effectiveness was strongly influenced by rates of wastage or misuse, and the ongoing costs of care for patients hospitalised with COVID-19. Interestingly, the cost or wastage of rapid antigen tests did not appear strongly influential over the cost-effectiveness of oral antivirals in any of the four study settings. Conclusions: Our results support that government funded COVID-19 booster programs continue to be cost-effective in middle-income settings. Oral antivirals demonstrate the potential to be cost-effective if procured at or below a middle-income reference price of $250 USD per schedule. Further research should quantify the rates of wastage or misuse of oral COVID-19 antivirals in middle-income settings.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

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