Cost-effectiveness analysis of COVID-19 vaccination in Poland

Abstract

IntroductionTo assess the potential value of the Comirnaty COVID-19 vaccination in Poland.Material and methodsMarkov model with 1-week cycles was used to estimate patient events, direct medical costs, utilities and cost-effectiveness for one year with and without implementing the Comirnaty vaccine in Poland. The incremental cost per quality-adjusted life-year (QALY) gained vs. no vaccine was calculated for the general population as well as for selected age-groups.ResultsIn the base case analysis the incremental cost per QALY gained associated with vaccinating the whole population amounted 6,249 PLN. For individuals aged 60-69 and >80 vaccination proved to be less costly and more effective than no vaccination. The incremental cost per QALY gained when vaccinating individuals aged 40-49 and 30-39 amounted 28,135 PLN and 67,823 PLN, respectively. In the general population and in younger subpopulations the incremental cost-effectiveness ratio was most sensitive to the vaccine effectiveness, vaccine price and SARS-CoV-2 infection rates.ConclusionsWhen prioritization is required due to supply constraints, vaccination of elderly is justified as it allows to achieve highest number of QALY gained and generates savings to the health care system. Continual update of the model concerning vaccine real-life effectiveness and epidemic course is required to refine the prioritisation scheme in the future.

Economic evaluation of COVID-19 vaccination: A systematic review

“…The two remaining studies were conducted in multiple countries; the first one comprised four analyses from LMICs and two analyses from HICs [ 36 ], while the other study comprised 12 analyses in LMICs [ 42 ]. Sixteen studies were conducted in 2021 [ 21 - 28 , 30 - 33 , 35 - 37 , 41 ], while nine studies were conducted in 2022 [ 29 , 34 , 38 - 40 , 42 - 45 ]. Most of the included studies (21/25) aimed to estimating the economic evaluation of different vaccination strategies [ 21 - 30 , 32 , 33 , 35 - 38 , 40 , 42 - 45 ], while two studies were conducted with the goal of estimating the economic evaluation of vaccination vs no vaccination [ 34 , 41 ].…”

“…Sixteen studies were conducted in 2021 [ 21 - 28 , 30 - 33 , 35 - 37 , 41 ], while nine studies were conducted in 2022 [ 29 , 34 , 38 - 40 , 42 - 45 ]. Most of the included studies (21/25) aimed to estimating the economic evaluation of different vaccination strategies [ 21 - 30 , 32 , 33 , 35 - 38 , 40 , 42 - 45 ], while two studies were conducted with the goal of estimating the economic evaluation of vaccination vs no vaccination [ 34 , 41 ]. Only one study assessed the economic impact of booster vaccination [ 31 ], while another compared the intradermal vaccine with the intramuscular vaccine [ 39 ].…”

“…Only one study did not report the perspective adopted [ 39 ] ( Table 2 ). At least four studies specified a vaccination coverage of less than 50% [ 21 , 27 , 30 , 40 ], eight had a vaccination coverage of 50%-75% [ 22 , 26 , 34 - 37 , 44 , 45 ], and one specified a vaccination coverage of 100% [ 41 ]. Moreover, three studies presented a range of two to three categories of vaccination coverage each [ 25 , 32 , 42 ].…”

“…Each analysis used a different evaluation to determine whether the use of vaccinations was considered cost-effective, e.g. by considering the procurement of the vaccine program compared with the absence of a vaccination program [ 21 , 26 , 33 , 36 , 39 , 41 , 45 , 48 , 50 ], the coverage of the vaccine used [ 37 , 40 , 42 , 49 ], the existence of priority vaccines for specific populations [ 25 , 30 , 33 , 34 , 38 , 41 ], the efficacy of many vaccines on the market [ 23 , 24 , 29 , 35 , 41 , 43 ], and the provision of boosters following vaccination [ 34 ].…”

“…Several studies did not conduct sensitivity analysis to determine the uncertainty of the analysis [ 24 , 28 , 39 , 41 , 43 ], but most did. Reproduction number [ 21 , 25 , 49 ], vaccine price/cost [ 22 , 23 , 33 , 41 , 48 ], vaccination program [ 26 , 42 , 45 ], vaccine efficacy [ 29 , 30 , 33 , 36 , 40 , 41 , 48 - 50 ], population/infection incidence [ 33 , 34 , 38 ], hospitalisation fee [ 35 ], and discount rate and mortality [ 37 ] were the most reported sensitive parameters in the sensitivity analysis. Vaccine cost was one of the most essential factors in determining cost-effectiveness.…”