Economic Evaluation of COVID-19 Immunization Strategies: A Systematic Review and Narrative Synthesis

Enxue Chang, Haofei Li, Wanji Zheng, Lan Zhou, Yanni Jia, Wen Gu, Yiyin Cao, Xiaoying Zhu (), Juan Xu, Bo Liu, Mao You, Kejun Liu (), Mingsi Wang () and Weidong Huang ()
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Enxue Chang: Harbin Medical University
Haofei Li: Harbin Medical University
Wanji Zheng: Harbin Medical University
Lan Zhou: Harbin Medical University
Yanni Jia: Harbin Medical University
Wen Gu: Harbin Medical University
Yiyin Cao: Harbin Medical University
Xiaoying Zhu: Nanjing University of Chinese Medicine
Juan Xu: Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center
Bo Liu: Shenzhen Health Capacity Building and Continuing Education Center
Mao You: National Health Development Research Center
Kejun Liu: National Health Development Research Center
Mingsi Wang: Harbin Medical University
Weidong Huang: Harbin Medical University

Applied Health Economics and Health Policy, 2024, vol. 22, issue 4, No 4, 457-470

Abstract: Abstract Objectives This study aimed to systematically assess global economic evaluation studies on COVID-19 vaccination, offer valuable insights for future economic evaluations, and assist policymakers in making evidence-based decisions regarding the implementation of COVID-19 vaccination. Methods Searches were performed from January 2020 to September 2023 across seven English databases (PubMed, Web of Science, MEDLINE, EBSCO, KCL-Korean Journal Dataset, SciELO Citation Index, and Derwent Innovations Index) and three Chinese databases (Wanfang Data, China Science and Technology Journal, and CNKI). Rigorous inclusion and exclusion criteria were applied. Data were extracted from eligible studies using a standardized data collection form, with the reporting quality of these studies assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022). Results Of the 40 studies included in the final review, the overall reporting quality was good, evidenced by a mean score of 22.6 (ranging from 10.5 to 28). Given the significant heterogeneity in fundamental aspects among the studies reviewed, a narrative synthesis was conducted. Most of these studies adopted a health system or societal perspective. They predominantly utilized a composite model, merging dynamic and static methods, within short to medium-term time horizons to simulate various vaccination strategies. The research strategies varied among studies, investigating different doses, dosages, brands, mechanisms, efficacies, vaccination coverage rates, deployment speeds, and priority target groups. Three pivotal parameters notably influenced the evaluation results: the vaccine's effectiveness, its cost, and the basic reproductive number (R0). Despite variations in model structures, baseline parameters, and assumptions utilized, all studies identified a general trend that COVID-19 vaccination is cost-effective compared to no vaccination or intervention. Conclusions The current review confirmed that COVID-19 vaccination is a cost-effective alternative in preventing and controlling COVID-19. In addition, it highlights the profound impact of variables such as dose size, target population, vaccine efficacy, speed of vaccination, and diversity of vaccine brands and mechanisms on cost effectiveness, and also proposes practical and effective strategies for improving COVID-19 vaccination campaigns from the perspective of economic evaluation.

Date: 2024
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DOI: 10.1007/s40258-024-00880-6

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