Identification of an Optimal COVID-19 Booster Allocation Strategy to Minimize Hospital Bed-Days with a Fixed Healthcare Budget

oleh: Ritika Kapoor, Baudouin Standaert, Edmund J. Pezalla, Nadia Demarteau, Kelly Sutton, Eszter Tichy, George Bungey, Sofie Arnetorp, Klas Bergenheim, Duncan Darroch-Thompson, Wilhelmine Meeraus, Lucas M. Okumura, Renata Tiene de Carvalho Yokota, Ray Gani, Terry Nolan

Format: Article
Diterbitkan: MDPI AG 2023-02-01

Deskripsi

Healthcare decision-makers face difficult decisions regarding COVID-19 booster selection given limited budgets and the need to maximize healthcare gain. A constrained optimization (CO) model was developed to identify booster allocation strategies that minimize bed-days by varying the proportion of the eligible population receiving different boosters, stratified by age, and given limited healthcare expenditure. Three booster options were included: B<sub>1</sub>, costing US $1 per dose, B<sub>2</sub>, costing US $2, and no booster (NB), costing US $0. B<sub>1</sub> and B<sub>2</sub> were assumed to be 55%/75% effective against mild/moderate COVID-19, respectively, and 90% effective against severe/critical COVID-19. Healthcare expenditure was limited to US$2.10 per person; the minimum expected expense using B<sub>1,</sub> B<sub>2,</sub> or NB for all. Brazil was the base-case country. The model demonstrated that B<sub>1</sub> for those aged <70 years and B<sub>2</sub> for those ≥70 years were optimal for minimizing bed-days. Compared with NB, bed-days were reduced by 75%, hospital admissions by 68%, and intensive care unit admissions by 90%. Total costs were reduced by 60% with medical resource use reduced by 81%. This illustrates that the CO model can be used by healthcare decision-makers to implement vaccine booster allocation strategies that provide the best healthcare outcomes in a broad range of contexts.