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. 2022 Sep:31:18-24.
doi: 10.1016/j.vhri.2022.01.009. Epub 2022 Mar 21.

Cost Utility of Vaccination Against COVID-19 in Brazil

Ricardo Ribeiro Alves Fernandes  1 , Marisa da Silva Santos  2 , Carlos Alberto da Silva Magliano  2 , Bernardo Rangel Tura  2 , Luana Schroeder Damico Nascimento Macedo  2 , Matheus Piccin Padila  2 , Ana Cláudia Wekmuller França  2 , Andressa Araujo Braga  2
Affiliations

Cost Utility of Vaccination Against COVID-19 in Brazil

Ricardo Ribeiro Alves Fernandes et al. Value Health Reg Issues. 2022 Sep.

Abstract

Objectives: The objective of this study was to evaluate the cost-utility of the Oxford, CoronaVac, and Janssen COVID-19 vaccines from the perspective of the Brazilian public health system.

Methods: A total of 3 microsimulation models were constructed with individual data to evaluate the 3 vaccines. The simulation contains 7 transition states that are related to the natural history of the disease. The model with a daily cycle has a time horizon of 1 year and uses data from 289 days of the pandemic. The analysis was conducted from the perspective of the Brazilian public health system considering direct medical costs. For the model inputs, outpatient and hospital databases were used with information on treated patients stratified by age. Information on mortality was also stratified based on patients' age in the mortality database (SIM). The efficacy of vaccines to reduce the likelihood of patients becoming ill was evaluated independently for each vaccine. Information on the quality of life of patients in outpatient or hospital treatment and the sequelae resulting from the disease were extracted from the literature. The main outcome of the analysis was quality-adjusted life-years (QALYs).

Results: The vaccines showed incremental cost-utility ratios ranging from R$-23 161.3/QALY (Oxford) to R$17 757.85/QALY (CoronaVac). The older the population, the lower was the incremental cost-utility ratio. Given a willingness-to-pay threshold of R$17 586/QALY, all the vaccines were considered cost-effective in the probabilistic sensitivity analysis.

Conclusions: The results of the analysis by age group can help in the preparation of a vaccination prioritization plan.

Keywords: COVID-19; HTA; cost-utility analysis; health technology assessment; vaccines.

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Figures

Figure 1
Figure 1
Schematic representation of the transition states of the model. ICU indicates intensive care unit.
Figure 2
Figure 2
Scatter plot of the cost-utility analysis of the (A) Oxford vaccine, (B) CoronaVac, and (C) Janssen vaccine. WTP indicates willingness to pay.
See this image and copyright information in PMC

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