Cost-Effectiveness of COVID-19 Vaccination in Latin America and the Caribbean: An Analysis in Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, and Peru

Background: No previous study has specifically assessed COVID-19 vaccination health and economic effects in Latin America and the Caribbean. Our study analyzes the cost-effectiveness of the COVID-19 vaccination campaign in Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, and Peru.Methods: Using a previously published SVEIR model, we analyzed the impact of a vaccination campaign (2021) from a national healthcare perspective. The primary outcomes were quality adjusted life years (QALYs) lost and total costs. Other outcomes included COVID-19 cases, hospitalizations, deaths, and life years. We applied a discount rate of 3%. We modeled a realistic vaccination campaign in each country (the country-specific campaign implemented). Additionally, we assessed a standard campaign (similar, 'typical' for all countries), and an optimized campaign (similar in all countries with higher but plausible population coverage). One-way deterministic sensitivity analyses of main parameters were performed.Findings: Vaccination was health improving as well as cost-saving in almost all countries and scenarios. Our analysis shows that vaccination in this group of countries prevented 573,141 deaths (508,826 standard; 685,442 optimized) and gained 5.07 million QALYs (4.53 standard; 6.03 optimized). Despite the incremental costs of vaccination campaigns, they had a total net cost saving to the health system of US$16.29 billion (US$16.47 standard; US$18.58 optimized). The realistic vaccination campaign in Chile was the only scenario, which was not cost saving, but it was still highly cost-effective with an ICER of US$22 per QALY gained. Main findings were robust in the sensitivity analyses.Interpretation: The COVID-19 vaccination campaign in seven Latin American and Caribbean countries -that comprise nearly 80% of the region- was beneficial for population health and was also cost-saving or highly cost-effective.Funding: Inter-American Development Bank (IDB)Declaration of Interest: In accordance with professional standards of transparency, we are reporting that William Savedoff, one of the co-authors, was employed by the Inter-American Development Bank when this research was being designed and conducted. He did not receive any financial remuneration from the IDB grant which partially supported this work. All other authors report no potential conflicts of interest. Ethical Approval: Neither consent nor ethics committee approval was necessary for this study. We carried out a modeling study with secondary data without any analysis or reporting of individual patient data.