In scenarios of vaccine scarcity or the context of organizational complexity, it is necessary to define prioritization strategies for allocating vaccine in compliance with the criteria of equity and efficiency of health resources. The COVIDIAGNOSTIX project, based on health technology assessment (HTA), assessed the role of SARS-CoV-2 serological tests as a companion diagnostic in the definition of strategies for vaccine administration. To guarantee evidence support for health policy choices, two different strategies were analyzed: one based on administering the vaccine booster dose to the entire population (VACCINE strategy) and the other based on allocation criteria (TEST&VACCINE strategy).

An Italian multidisciplinary team conducted a decision-oriented HTA using a combination of the EUnetHTA Core Model and the multicriteria decision analysis model based on the Analytic Hierarchy Process.

Moreover, the Department of HTA method was integrated with the Susceptible-Exposed-Infectious-Recovered model, appropriate modelling techniques, simulation, and quantification of uncertainty that considered the ability to reduce deaths and to contain the pandemic. After identifying the evaluation elements and the decision-making structure, the weights of the evaluation areas and key performance indicators were calculated. This is a constituent part of the mathematical model of data processing, as the Analytic Hierarchy Process was based on a structured questionnaire that compared the relative importance of the two elements on a qualitative scale (1=equal importance; 9=more important).

The processing of the scores attributed to the key performance indicators concerning all the evaluation domains resulted in a performance of 94 percent for the TEST&VACCINE strategy and 84 percent for the VACCINE strategy. The TEST&VACCINE strategy was the most advantageous in various scenarios due to the greater speed of response from an operational and economic point of view.

The assessment schemes defined by COVIDIAGNOSTIX (i.e., technologies, intended use, and settings), which highlight the characteristics that differentiate the tests from each other and guarantee a timely and appropriate evaluation, can be adapted to respond to similar health policy management situations.