日本老年人接种 NVX-CoV2373 COVID-19 疫苗的成本效益分析

IF 2.7 Q3 IMMUNOLOGY Vaccine: X Pub Date : 2024-06-20 DOI:10.1016/j.jvacx.2024.100514

Masafumi Kato , Takayori Ono , Hisato Deguchi , Norio Ohmagari , Ataru Igarashi

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引用次数: 0

摘要

背景NVX-CoV2373 是日本市场上用于预防 COVID-19 的疫苗之一。关于其成本效益的信息对于从公共医疗支付方的角度就日本 COVID-19 疫苗接种计划的未来做出明智决策非常重要。本研究的目的是评估日本老年人群接种 NVX-CoV2373 疫苗的成本效益。方法本研究定义了包括日本老年人（年龄≥ 65 岁）在内的两个分析人群：未接种过 COVID-19 疫苗或未完成已获批准的 COVID-19 疫苗初级接种系列（即前两次接种）的人群（分析人群 1），以及已接种过两次已获批准的 COVID-19 疫苗初级接种的人群（分析人群 2）。我们为每个分析人群建立了一个文献信息马尔可夫模型，以便从公共医疗支付方的角度评估接种 NVX-CoV2373 与不接种 NVX-CoV2373 的成本效益，作为基础案例分析，以及从社会角度评估成本效益，作为情景分析。疫苗疗效根据 NVX-CoV2373 3 期研究（EudraCT 编号：2020-004123-16）进行估算。成本效益评估采用的支付意愿阈值为每质量调整生命年（QALY）500 万日元。结果对于分析人群 1，NVX-CoV2373 初次接种和加强接种可降低成本 37,647 日元，延长 QALYs 0.01601。因此，接种 NVX-CoV2373 初次接种和加强接种被认为优于不接种。结论我们的分析表明，NVX-CoV2373 疫苗接种策略在日本老年人群（年龄≥ 65 岁）中具有成本效益。

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Cost-effectiveness analysis of NVX-CoV2373 COVID-19 vaccination for elderly people in Japan

Background

NVX-CoV2373 is one of the vaccines marketed for COVID-19 prevention in Japan. Information on its cost-effectiveness is important for making well-informed decisions on the future of Japan’s COVID-19 vaccination programme from the public healthcare payer’s perspective. The aim of this study was to evaluate the cost-effectiveness of NVX-CoV2373 vaccination in the elderly Japanese population.

Methods

Two analysis populations that included elderly Japanese individuals (aged ≥ 65 years) were defined in this study: those who had not received a COVID-19 vaccine or had not completed a primary vaccination series (i.e., first two vaccinations) with an approved COVID-19 vaccine (analysis population 1), and those who had received two primary vaccinations with an approved COVID-19 vaccine (analysis population 2). A literature-informed Markov model for each analysis population was developed to evaluate the cost-effectiveness of vaccination with NVX-CoV2373 against no vaccination with NVX-CoV2373 from the public healthcare payer’s perspective as a base-case analysis and from the societal perspective as a scenario analysis. Vaccine efficacy was estimated from a phase 3 study of NVX-CoV2373 (EudraCT number: 2020–004123-16). Cost-effectiveness was assessed using a willingness-to-pay threshold of Japanese yen (JPY) 5 million per quality-adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses were also performed.

Results

For analysis population 1, NVX-CoV2373 primary and booster vaccinations would reduce costs by JPY 37,647 and prolong QALYs by 0.01601. Therefore, NVX-CoV2373 primary and booster vaccinations were considered to be dominant over no vaccination. For analysis population 2, an NVX-CoV2373 booster vaccination would increase costs by JPY 5010 and prolong QALYs by 0.00550, with the incremental cost-effectiveness ratio of JPY 910,566 per QALY gained.