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Modeling the cost-effectiveness of the next-generation COVID-19 mRNA-1283 vaccine in the United States
Kelly Fust1, Michele Kohli1, Keya Joshi2
1Quadrant Health Economics, Inc, Cambridge, ON, Canada.
Insights
The new mRNA-1283 COVID-19 vaccine is a cost-effective strategy for adults 65 and older and high-risk individuals. It is estimated to dominate existing mRNA vaccines, offering a valuable option for US immunization programs.
Area of Science:
- Epidemiology
- Health Economics
- Vaccinology
Background:
- The United States faces a high COVID-19 disease burden, particularly among adults aged 65 and older and individuals with underlying medical conditions.
- Assessing the economic value of new vaccine technologies is crucial for public health resource allocation.
Purpose of the Study:
- To estimate the cost-effectiveness of the next-generation COVID-19 mRNA-1283 vaccine.
- To compare mRNA-1283 against no annual vaccination and currently licensed mRNA vaccines (mRNA-1273 and BNT162b2).
- To evaluate the vaccine's value in high-risk adults aged 12-64 and all adults aged 65 and older.
Main Methods:
- A static decision-analytic model with a 1-year horizon was utilized for the analysis.
- Relative vaccine effectiveness (rVE) data from clinical trials and real-world evidence were used to estimate the performance of mRNA-1283.
- Societal incremental cost per quality-adjusted life-year (QALY) gained and benefit-cost ratio (BCR) were calculated.
Main Results:
- A single dose of mRNA-1283 was projected to cost $16,247 per QALY gained compared to no vaccination for the 2025/2026 season.
- The benefit-cost ratio for mRNA-1283 ranged from $2.16 to $9.74 for every $1 spent.
- mRNA-1283 was estimated to be more effective and cost-efficient than originally licensed mRNA vaccines in the target populations.
Conclusions:
- mRNA-1283 presents a highly cost-effective strategy for reducing COVID-19 burden, falling within typical willingness-to-pay thresholds.
- Based on assumed rVE, mRNA-1283 is projected to outperform existing mRNA vaccines for the studied populations.
- This vaccine could significantly enhance US COVID-19 immunization strategies and protect vulnerable groups.
Aims:
COVID-19 disease burden in United States (US) adults ≥65 years and persons with underlying medical conditions remains high. This modeling study estimated the cost-effectiveness of the next-generation COVID-19 mRNA-1283 vaccine in persons aged 12-64 at high risk of severe COVID-19 outcomes and all adults ≥65 years.
Methods:
mRNA-1283 was compared with no annual vaccination and originally licensed mRNA vaccines mRNA-1273 and BNT162b2. Analyses were conducted using a static decision-analytic model (1-year horizon). Vaccine effectiveness (VE) against infection and hospitalization for mRNA-1283 versus no vaccination was based on relative VE (rVE) from the Phase 3 pivotal randomized controlled trial comparing mRNA-1283 against mRNA-1273, and mRNA-1273 real-world data. rVE estimates for mRNA-1283 versus BNT162b2 were based on an indirect treatment comparison. The societal incremental cost per quality-adjusted life-year (QALY) gained and the benefit-cost ratio (BCR) were calculated.
Results:
During the 2025/2026 season, a single dose of mRNA-1283 was estimated to yield an incremental cost per QALY gained of $16,247 compared with no vaccine. The BCR for the base case strategy ranged from $2.16-9.74 returned for every $1 spent for mRNA-1283. mRNA-1283 was estimated to dominate originally-licensed mRNA-COVID-19 vaccines in analyses of the target population. Results were sensitive to COVID-19 incidence, hospitalization rates, post-discharge mortality rates, and VE.
Limitations:
The real-world effectiveness and safety of mRNA-1283 have not yet been established, and relative VE estimates should be validated with real-world data. Full year 2025/2026 COVID-19 incidence and vaccine uptake in the US is uncertain.
Conclusions:
Study results suggest mRNA-1283 may represent a highly cost-effective strategy (considering a $100,000-150,000 per QALY willingness-to-pay threshold) to reduce COVID-19 burden. Based on rVE assumptions made, mRNA-1283 was estimated to dominate originally-licensed mRNA vaccines in this recommended population. mRNA-1283 may provide a valuable option to optimize US COVID-19 immunization programs and protect those most vulnerable.
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