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

Huixuan Zhou; Ningxin Ding; Xueyan Han; Hanyue Zhang; Zeting Liu; Xiao Jia; Jingjing Yu; Wei Zhang

doi:10.3389/fpubh.2023.1037556

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

Front Public Health. 2023 Mar 7:11:1037556. doi: 10.3389/fpubh.2023.1037556. eCollection 2023.

Authors

Huixuan Zhou^{1

2}, Ningxin Ding³, Xueyan Han⁴, Hanyue Zhang⁵, Zeting Liu⁶, Xiao Jia², Jingjing Yu², Wei Zhang⁷

Affiliations

¹ Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.
² Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China.
³ School of Government, Wellington School of Business and Government, Victoria University of Wellington, Wellington, New Zealand.
⁴ School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
⁵ School of Physical Education, North East Normal University, Jilin City, China.
⁶ Department of Mathematic Science, School of Sport Engineering, Beijing Sport University, Beijing, China.
⁷ Department of Chemical Drug Control, China National Institute for Food and Drug Control, Beijing, China.

Abstract

Introduction: Since September 2020, Chinese populations aged > 3 years have been encouraged to receive a two-dose inoculation with vaccines against coronavirus disease 2019 (COVID-19). This study aims to evaluate the cost-effectiveness of the current vaccination strategy amongst the general population in mainland China from a societal perspective.

Methods: In this study, we construct a decision tree with Markov models to compare the economic and health consequences of the current vaccination strategy versus 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 literature. Outcome measures include infection rates, death rates, quality-adjusted life years (QALYs), and costs. The incremental cost-effectiveness 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.

Results: Our simulation indicates that compared with a no-vaccination scenario, vaccination amongst the general population in mainland China would reduce the infection rate from 100% to 45.3% and decrease the death rate from 6.8% to 3.1%. Consequently, the strategy will lead to a saving of 37,664.77 CNY (US$5,256.70) and a gain of 0.50 QALYs per person per year on average (lifetime QALY and productivity loss due to immature death are included). The cost-saving for each QALY gain is 74,895.69 CNY (US$10,452.85). Result of the PSA indicates that vaccination is the dominating strategy with a probability of 97.9%, and the strategy is cost-effective with a probability of 98.5% when the willingness-to-pay (WTP) is 72,000 CNY (US$10,048.71) per QALY.

Conclusion: Compared with a no-vaccination scenario, vaccination among the general population in mainland China is the dominating strategy from a societal perspective. The conclusion is considered robust in the sensitivity analyses.

Keywords: COVID-19; SARS-CoV-2; cost-effectiveness analysis; cost-utility analysis; vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / prevention & control
China / epidemiology
Cost-Benefit Analysis
Cost-Effectiveness Analysis*
Humans
Vaccination

Grants and funding

This study was supported by the Annual Report on Intelligent Upgrading of National Physical Fitness Testing Technology, Ministry of Science and Technology of the People's Republic of China (Grant No. 2020YFC2006701). The funders had no role in the identification, design, conduct, and reporting of the analysis.