Assessing the Budget Impact of COVID-19 Vaccines on US Commercial Payers

A study estimated the one-year budgetary impact of annual COVID-19 vaccines from a US third-party payer perspective. The results were published as a poster at AMCP Nexus 2021.

“The COVID-19 pandemic has had a tremendous global impact and reaching herd immunity through vaccine distribution is an important step. An annual booster may be needed to maintain herd immunity post-pandemic. High uptake of these new vaccine technologies in a short time frame may result in unprecedented impacts on commercial payer budgets,” the researchers wrote.

In this study, researchers compared costs between two scenarios: vaccine distribution phase and speculative herd immunity phase with annual booster dose. From a US commercial payer perspective, all direct medical costs in 2020 were considered. Total costs and per member per month (PMPM) costs over one year were calculated for a commercial plan comprising one million adults. Researchers used a model that analyzed the costs of the vaccine, administration, COVID-19 related hospitalization, and vaccine anaphylaxis–related hospitalization.

The analysis revealed that over half (52%) of individuals were projected to receive a theoretical annual COVID-19 booster, at a similar rate as the flu vaccine in 2020. The one-year cost saving with an annual COVID-19 booster was $27,037,865. PMPM costs were $2.25 lower in post-pandemic circumstances. The cost offsets mainly came from reduced COVID-19 hospitalization. In the sensitivity analyses, the most influential variables were vaccine costs and COVID-19 hospitalization costs. The model results remained robust in sensitivity analyses.

“Total and PMPM costs of annual COVID-19 booster doses were lower after herd immunity was reached versus during the initial vaccination drive,” the researchers concluded. They added that, however, “the annual budget impact may vary in subsequent years based on changes in vaccine benefit/risk, costs, and disease management.”

Source: Lee L, et al. Budget Impact Analysis of COVID-19 Vaccines on US Commercial Payers. Poster U12. Published for AMCP Nexus 2021; October 18-21, 2021, Denver, CO.