AUTHOR=Zhou Huixuan , Ding Ningxin , Han Xueyan , Zhang Hanyue , Liu Zeting , Jia Xiao , Yu Jingjing , Zhang Wei 

TITLE=Cost-effectiveness analysis of vaccination against COVID-19 in China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1037556

DOI=10.3389/fpubh.2023.1037556

ISSN=2296-2565

ABSTRACT=Chinese populations aged > 3 years have been encouraged to have a two-dose inoculation by vaccines against COVID-19 since September 2020. This study aims to evaluate the cost-effectiveness of the current vaccination strategy amongst the general population in mainland China from a societal perspective. In this study, we construct a decision tree with Markov models to compare the economic and health consequences a current vaccination strategy and a no vaccination scenario, over a time horizon of one year and an annual discount rate of 5%. Transition probabilities, health utilities, healthcare costs, and productivity losses are estimated from literatures. Outcome measures include infection rates, death rates, total QALYs, and total costs. The incremental cost-effective ratio (ICER) is then calculated to evaluate the cost-effectiveness of the current vaccination strategy, and both one-way deterministic sensitivity analysis and probabilistic sensitivity analysis (PSA) are applied to assess the impact of uncertainties on results. Our simulation indicates that compared with the not vaccinated scenario, vaccination amongst the general population in mainland China will reduce infection rate from 100% to 45.3%, death rate from 6.8% to 3.1%, respectively. Consequently, the strategy will lead to a save of 37,664.77 CNY (5,256.70 USD), and a gain of 0.50 QALYs per person per year on average. The cost saving of vaccination for each QALY is 74,895.69 CNY (10,452.85 USD). The cost-effectiveness acceptability curve indicates that vaccination would maintain as the dominating strategy with a probability of 97.9%, and would be cost-effective with a probability of 98.5% when the willingness-to-pay is 72,000 CNY (10,048.71 USD) per QALY. We conclude that compared with the not vaccinated scenario, vaccination amongst the general population in mainland China is the dominating strategy from a societal perspective. The conclusions are considered robust in the sensitivity analyses.