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. 2023 Jul;24(5):735-748.
doi: 10.1007/s10198-022-01505-2. Epub 2022 Aug 11.

Assessing the cost-effectiveness of COVID-19 vaccines in a low incidence and low mortality setting: the case of Thailand at start of the pandemic

Yi Wang  1 , Nantasit Luangasanatip  2 , Wirichada Pan-Ngum  2 , Wanrudee Isaranuwatchai  3 , Juthamas Prawjaeng  4 , Sompob Saralamba  2 , Christopher Painter  2   4 , Jamaica Roanne Briones  1 , Yot Teerawattananon  1   4
Affiliations

Assessing the cost-effectiveness of COVID-19 vaccines in a low incidence and low mortality setting: the case of Thailand at start of the pandemic

Yi Wang et al. Eur J Health Econ. 2023 Jul.

Abstract

Objective: This study aimed to assess the cost-effectiveness of COVID-19 vaccines, preferred COVID-19 vaccine profiles, and the preferred vaccination strategies in Thailand.

Methods: An age-structured transmission dynamic model was developed based on key local data to evaluate economic consequences, including cost and health outcome in terms of life-years (LYs) saved. We considered COVID-19 vaccines with different profiles and different vaccination strategies such as vaccinating elderly age groups (over 65s) or high-incidence groups, i.e. adults between 20 and 39 years old who have contributed to more than 60% of total COVID-19 cases in the country thus far. Analyses employed a societal perspective in a 1-year time horizon using a cost-effectiveness threshold of 160,000 THB per LY saved. Deterministic and probabilistic sensitivity analyses were performed to identify and characterize uncertainty in the model.

Results: COVID-19 vaccines that block infection combined with social distancing were cost-saving regardless of the target population compared to social distancing alone (with no vaccination). For vaccines that block infection, the preferred (cost-effective) strategy was to vaccinate the high incidence group. Meanwhile, COVID-19 vaccines that reduces severity (including hospitalization and mortality) were cost-effective when the elderly were vaccinated, while vaccinating the high-incidence group was not cost-effective with this vaccine type. Regardless of vaccine type, higher vaccination coverage, higher efficacy, and longer protection duration were always preferred. More so, vaccination with social distancing measures was always preferred to strategies without social distancing. Quarantine-related costs were a major cost component affecting the cost-effectiveness of COVID-19 vaccines.

Conclusion: COVID-19 vaccines are good value for money even in a relatively low-incidence and low-mortality setting such as Thailand, if the appropriate groups are vaccinated. The preferred vaccination strategies depend on the type of vaccine efficacy. Social distancing measures should accompany a vaccination strategy.

Keywords: COVID-19; Cost-effectiveness; Economic evaluation; SARS-CoV-2; Thailand; Vaccination; Vaccine.

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Figures

Fig. 1
Fig. 1
Cost-effectiveness plane – Different Vaccination Strategies for blocking infection and reducing severity
Fig. 2
Fig. 2
Cost-effectiveness Plane – Different Vaccine Profiles for blocking infection and reducing severity
Fig. 3
Fig. 3
Deterministic Sensitivity Analysis
Fig. 4
Fig. 4
Probabilistic Sensitivity Analysis
Fig. 5
Fig. 5
Expected incremental NMB vs Probability of Vaccine Blocking Transmission
Fig. 6
Fig. 6
EVPI vs Probability of vaccine blocking infection
See this image and copyright information in PMC

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