OBJECTIVES: The introduction of the Novavax vaccine to the coronavirus disease 2019 (COVID-19) vaccine market has the potential to increase vaccine coverage in the United States (US), where coverage has lagged compared with other high-income countries. This modeling study estimated the cost-effectiveness of including the Novavax vaccine as a potential booster vaccine option for previously vaccinated adults in the US.
METHODS: A Markov model was developed to estimate COVID-19–related cases, hospitalizations, and deaths with and without the Novavax vaccine as a booster vaccine option. The model population included those boosted and those not boosted and was stratified by age, with health states including susceptible, detected infection, long COVID-19, and recovered. The severity of COVID-19 outcomes among detected infections was based on the highest level of care required. Booster vaccine efficacy was assumed to equal primary vaccine efficacy, sourced from published phase 3 clinical trials based primarily on the prototype variant. Efficacy was assumed to wane equally for all vaccines. Costs per dose were assumed to be equal for all booster vaccines. Other model parameters were sourced from published literature. We estimated the cost-effectiveness from a payer perspective (direct medical costs only) over a 1-year time horizon. Scenario analyses were conducted to investigate the impact of age, coverage assumptions, and analysis perspective on model outcomes.
RESULTS: A 5% increase in booster vaccine coverage among a cohort of 100,000 adults eligible for booster vaccination, allocated to the Novavax vaccine market share, resulted in 20.00 quality-adjusted life-years (QALY) gained at an incremental cost of $2,082. The incremental cost-effectiveness ratio of adding the Novavax vaccine as a booster option was $104/QALY gained.
CONCLUSIONS: Our results suggest that including the Novavax vaccine as a potential COVID-19 booster option for adults in the US has the potential to be cost-effective across a variety of coverage and market share scenarios.
