Evaluation of vaccine allergy safety track program to assess potential COVID-19 vaccine allergy: a cost-effectiveness analysis.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-09-22 DOI:10.12932/AP-270524-1864

Xuechen Xiong, Zhaohua Huo, Valerie Chiang, Jiaxi Ye, Yuh Dong Hong, Xingnan Yi, Carmen S Ng, Philip H Li, Jianchao Quan

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Abstract

Background: Concerns about new COVID-19 vaccines played a key role in vaccine hesitancy and hampered population uptake. Hong Kong initiated a Vaccine Allergy Safety Track (VAS-Track) program to assess potential COVID-19 vaccine-associated allergies. A 'Hub-and-Spoke' model of predominately non-specialists supported by the allergist hub was established to meet overwhelming demand despite limited specialists.

Objective: To assess the cost-effectiveness of VAS-Track as a pre- and post-vaccination assessment service for individuals potentially at high risk of COVID-19 vaccine-related allergy.

Methods: An individual-level decision-analytical model was constructed using data from VAS-Track participants supplemented by published estimates. Analyses were from a health service provider perspective over 12 months. We calculated the incremental cost-effectiveness ratio (ICER) to estimate the cost per quality-adjusted life years (QALYs) gained. Willingness-to-pay threshold was based on local GDP per capita (US$ 49,590). Sensitivity analyses examined robustness of findings.

Results: Cost-effectiveness varied widely across age groups. VAS-Track was cost-saving for older adults (dominant strategy for age ≥ 50) compared with standard practice across a range of sensitivity analyses. VAS-Track was not cost-effective for younger groups (age 18-49: ICER: US$ 410,914/QALY for pre-vaccination and US$ 213,786/QALY for post-vaccination assessments). Infection rate, cost of treating severe infection, and vaccination rate were most influential on cost-effectiveness estimates.

Conclusion: VAS-Track was cost-effective both as a pre- and post-vaccination assessment service for adults over 50. The 'Hub-and-Spoke' model using non-specialists with limited allergy specialist resources to provide vaccine allergy assessment services would provide high economic value compared with usual care for adults aged 50 and over.

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评估潜在 COVID-19 疫苗过敏的疫苗过敏安全跟踪计划：成本效益分析。

背景：对新型 COVID-19 疫苗的担忧是导致人们对疫苗犹豫不决的关键因素，并阻碍了疫苗的普及。香港启动了疫苗过敏安全追踪（VAS-Track）计划，以评估潜在的 COVID-19 疫苗相关过敏症。在过敏症中心的支持下，建立了以非专科医生为主的 "中心辐射"（Hub-and-Spoke）模式，以便在专科医生有限的情况下满足大量需求：目的：评估 VAS-Track 作为疫苗接种前和接种后评估服务对 COVID-19 疫苗相关过敏潜在高危人群的成本效益：方法：利用 VAS-Track 参与者的数据，并辅以已公布的估算值，构建了个人层面的决策分析模型。从医疗服务提供者的角度进行了为期 12 个月的分析。我们计算了增量成本效益比 (ICER)，以估算每获得质量调整生命年 (QALY) 的成本。支付意愿阈值基于当地人均 GDP（49,590 美元）。敏感性分析检验了研究结果的稳健性：不同年龄组的成本效益差异很大。在一系列敏感性分析中，VAS-Track 对老年人（年龄≥ 50 岁的主要策略）与标准实践相比具有成本节约效果。VAS-Track 对年轻群体不具成本效益（18-49 岁：接种前评估的 ICER 为 410,914 美元/QALY，接种后评估的 ICER 为 213,786 美元/QALY）。感染率、治疗严重感染的成本和疫苗接种率对成本效益估算的影响最大：VAS-Track作为50岁以上成年人的疫苗接种前和接种后评估服务都具有成本效益。利用非专科医生和有限的过敏专科医生资源提供疫苗过敏评估服务的 "中心辐射 "模式与常规护理相比，将为 50 岁及以上的成年人提供较高的经济价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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