Clinical impact and cost-effectiveness of the updated COVID-19 mRNA Autumn 2023 vaccines in Germany

Abstract

Objectives

To assess the potential clinical impact and cost-effectiveness of coronavirus disease 2019 (COVID-19) mRNA vaccines updated for Autumn 2023 in adults aged ≥60 years and high-risk persons aged 30–59 years in Germany over a 1-year analytic time horizon (September 2023–August 2024).

Methods

A compartmental Susceptible-Exposed-Infected-Recovered model was updated and adapted to the German market. Numbers of symptomatic infections, a number of COVID-19 related hospitalizations and deaths, costs, and quality-adjusted life-years (QALYs) gained were calculated using a decision tree model. The incremental cost-effectiveness ratio of an Autumn 2023 Moderna updated COVID-19 (mRNA-1273.815) vaccine was compared to no additional vaccination. Potential differences between the mRNA-1273.815 and the Autumn Pfizer-BioNTech updated COVID-19 (XBB.1.5 BNT162b2) vaccines, as well as societal return on investment for the mRNA-1273.815 vaccine relative to no vaccination, were also examined.

Results

Compared to no autumn vaccination, the mRNA-1273.815 campaign is predicted to prevent approximately 1,697,900 symptomatic infections, 85,400 hospitalizations, and 4,100 deaths. Compared to an XBB.1.5 BNT162b2 campaign, the mRNA-1273.815 campaign is also predicted to prevent approximately 90,100 symptomatic infections, 3,500 hospitalizations, and 160 deaths. Across both analyses we found the mRNA-1273.815 campaign to be dominant.

Conclusions

The mRNA-1273.815 vaccine can be considered cost-effective relative to the XBB.1.5 BNT162b2 vaccine and highly likely to provide more benefits and save costs compared to no vaccine in Germany, and to offer high societal return on investment.

Keywords:

• Coronavirus
• SARS-CoV-2
• Germany
• COVID-19
• vaccination
• cost-effectiveness

JEL Classification Codes:

• H00
• H
• I00
• I

Transparency

Declaration of funding

This study was funded by Moderna, Inc. Employees of Moderna participated in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.

Declaration of financial/other relationships

EB, KJ, SS, BU, and NVV are employees of Moderna and may hold stock/stock options in the company. MK is a shareholder in Quadrant Health Economics Inc, which was contracted by Moderna, Inc., to conduct this study. KF, AL, and MM are consultants at Quadrant Health Economics Inc.

Author contributions

AL, EB, KF, KJ, MK, MM, SS, BU, and NVV were involved in study design and interpretation of the analysis. KJ and SS programmed the model and conducted the analysis. EB, KJ, SS, and BU contributed to development of the initial draft of the manuscript, and all remaining co-authors critically revised the manuscript and approved the final version.

Acknowledgements

Medical writing and editorial assistance were provided by K Ian Johnson of MEDiSTRAVA, in accordance with Good Publication Practice (GPP) guidelines, funded by Moderna, Inc., and under the direction of the authors.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.