Modeling the cost-effectiveness of NVX-CoV2705 and the public health impact of vaccination for the prevention of seasonal COVID-19 in the US.

Abstract

Older adults and those with comorbidities have increased risk of severe disease and mortality from COVID-19. This analysis estimated the cost-effectiveness of COVID-19 vaccination versus no vaccination in the US and potential impact of increased vaccine coverage. A Markov-based model was updated using the latest epidemiology and vaccine reactogenicity data. Cases, costs, and outcomes for individuals aged 18-64 with ≥1 comorbidity and ≥65 years were estimated for NVX-CoV2705 (Nuvaxovid) versus no vaccination from a third-party payer perspective. Scenario analyses considered the societal perspective and analogous comparisons for BNT162b2 (Comirnaty), mRNA-1273 (Spikevax), and mRNA-1283 (mNEXSPIKE). Results were scaled for public health impact analyses. Base-case results associated NVX-CoV2705 with fewer cases (0.0447), hospitalizations (0.0037), and deaths (0.0004) per person on average. NVX-CoV2705 yielded an ICER of $9,840/QALY gained, reflecting fewer QALYs lost (0.0039) alongside increased direct costs ($38.09) per person. Differences for mRNA vaccines were driven by price and reactogenicity. Increasing vaccine coverage by 5-15 percentage points resulted in 114-341 hospitalizations and 11-33 deaths averted per 1,000,000 individuals. NVX-CoV2705 was predicted to be cost-effective over no vaccination. This analysis included a more granular approach to modeling reactogenicity events, an important consideration in vaccine cost-effectiveness analyses. SARS-CoV-2 infection can still lead to serious COVID-19 illness, especially in older adults and people with health conditions such as diabetes, heart disease, or cancer. Vaccination remains an important way to help protect people from severe COVID-19 and its complications. This study examined the health and economic impact of COVID-19 vaccination in the US. Researchers evaluated whether vaccination with NVX-CoV2705 (a non-mRNA vaccine) is worth the money it costs compared to not being vaccinated. The study considered healthcare costs, quality of life, and broader societal effects such as daily life and work. It expands upon a prior model by using the latest available data on COVID-19 infections and vaccine reactogenicity, including a closer look at vaccine side effects and how they factor into a vaccine’s overall value. The results indicate that people vaccinated with NVX-CoV2705 were expected to experience fewer COVID-19 cases, hospitalizations, and deaths than those not vaccinated. Vaccination with NVX-CoV2705 has some upfront costs (such as the cost of the vaccine and treatment of side effects), but it leads to better overall health outcomes and can avoid some of the costs associated with COVID-19. Results show that being vaccinated with NVX-CoV2705 or with an mRNA COVID-19 vaccine is worth the money. This study also estimated what might happen if more people received a COVID-19 vaccine. Even modest increases in vaccination coverage could prevent additional hospitalizations and deaths across the US. Greater awareness of vaccine benefits and side effects may help people feel more confident in their vaccination decisions.