Global return-on-investment of COVID-19 vaccines in the first year of the vaccination programme: A model-based economic evaluation

Background: COVID-19 vaccines played a critical role in reducing global health burden during the COVID-19 pandemic, but their rapid development required extraordinary effort. This study aims to evaluate their global return-on-investment (ROI) during the first year of the vaccination programme (8 December 2020–8 December 2021) to provide insights into the economic benefits relative to the costs of vaccine development, manufacturing, and delivery. Methods and findings: Public health outcomes of COVID-19 vaccination, including life years and quality-adjusted life years (QALYs) gained from averted deaths, infections, and hospitalizations, were estimated. Health benefits were valued using two approaches: i) cost-benefit analysis and ii) cost-effectiveness analysis. These benefits were compared to the costs of vaccine development, manufacturing, and delivery to estimate the ROI under both approaches. Probabilistic sensitivity analyses were conducted to assess the impact of parameter uncertainty on ROI estimates. Vaccine development and delivery cost $79.4 billion, but the health and economic benefits of vaccination were valued between $6.43 and $64.3 trillion. High-income countries saw the greatest health benefits per-person vaccinated, and low-income countries gained the greatest nonhealth benefits per-person vaccinated, when expressed as a proportion of gross domestic product per capita. This estimated ROIs of $59.7–$809 per dollar invested in the base case analysis. ROIs ranged between $60.3–$753 across probabilistic sensitivity analyses for both approaches. Limitations include reliance on previous analyses of COVID-19 vaccination impact and a time horizon limited to the first year of COVID-19 vaccination. Conclusions: Rapid COVID-19 vaccine development and delivery were an excellent investment. Vaccine development and equitable vaccine distribution globally should be prioritized before and during global health crises. Why was this study done?: What did the researchers do and find?: What do these findings mean?: In this model-based economic evaluation, Hallie Benjamin and colleagues compare the costs of vaccine development, manufacturing, and delivery with estimated health and economic benefits during the first year of the COVID-19 vaccination programme. The study suggests it was associated with substantial value relative to investment across countries, with estimated benefits far exceeding costs and highlighting the potential importance of vaccine development and equitable distribution during global health emergencies.