tetano
Editor, Senior Moderator
Am J Prev Med
. 2023 Apr 8;S0749-3797(23)00035-1.
doi: 10.1016/j.amepre.2023.01.028. Online ahead of print.
Cost-Effectiveness and Health Impacts of Different Influenza Vaccination Strategies for Children in China
Yilin Gong[SUP] 1 [/SUP], Xuelin Yao[SUP] 2 [/SUP], Jin Peng[SUP] 2 [/SUP], Yue Ma[SUP] 2 [/SUP], Yu Fang[SUP] 2 [/SUP], Kangkang Yan[SUP] 3 [/SUP], Minghuan Jiang[SUP] 4 [/SUP]
Affiliations
Abstract
Introduction: We aimed to evaluate the economic and health impacts of 3 influenza vaccines available in China, including trivalent inactivated vaccine, quadrivalent inactivated vaccine, and live attenuated influenza vaccine, for children aged 6 months to 18 years.
Methods: Two decision-analytic models were developed to simulate 4 vaccination strategies. Outcomes included total costs from a societal perspective in 2021, quality-adjusted life-year loss, numbers of outpatient and inpatient cases, and deaths avoided using each strategy. Deterministic and probabilistic sensitivity analyses were performed to examine the uncertainty of model inputs.
Results: For children aged 6 months to 3 years, trivalent inactivated vaccine saved $48 million and avoided a loss of 17,637 quality-adjusted life-years compared with no vaccination. For children aged 3-18 years, quadrivalent inactivated vaccine was cost-effective compared with trivalent inactivated vaccine, with an incremental cost-effectiveness ratio of $32,948.5/quality-adjusted life-year (willingness-to-pay threshold=$37,653/quality-adjusted life-year), which was sensitive to the RR of vaccine effectiveness of quadrivalent inactivated vaccine versus of trivalent inactivated vaccine. When compared with quadrivalent inactivated vaccine, live attenuated influenza vaccine was $1.28 billion more costly but gained an additional 13,560 quality-adjusted life-years; its incremental cost-effectiveness ratio was $123,983.8/quality-adjusted life-year. Live attenuated influenza vaccine would be cost-effective if its vaccine effectiveness was >0.79. Probabilistic sensitivity analysis revealed that quadrivalent inactivated vaccine, trivalent inactivated vaccine, live attenuated influenza vaccine, and no vaccination were cost-effective in 55.94%, 33.09%, 10.97%, and 0% of 10,000 Monte Carlo simulations.
Conclusions: Trivalent inactivated vaccine was cost-effective compared with no vaccination in children aged 6 months to 18 years. Of the 3 vaccination strategies for children aged 3-18 months, quadrivalent inactivated vaccine appears to be the most cost-effective.
. 2023 Apr 8;S0749-3797(23)00035-1.
doi: 10.1016/j.amepre.2023.01.028. Online ahead of print.
Cost-Effectiveness and Health Impacts of Different Influenza Vaccination Strategies for Children in China
Yilin Gong[SUP] 1 [/SUP], Xuelin Yao[SUP] 2 [/SUP], Jin Peng[SUP] 2 [/SUP], Yue Ma[SUP] 2 [/SUP], Yu Fang[SUP] 2 [/SUP], Kangkang Yan[SUP] 3 [/SUP], Minghuan Jiang[SUP] 4 [/SUP]
Affiliations
- PMID: 37037733
- DOI: 10.1016/j.amepre.2023.01.028
Abstract
Introduction: We aimed to evaluate the economic and health impacts of 3 influenza vaccines available in China, including trivalent inactivated vaccine, quadrivalent inactivated vaccine, and live attenuated influenza vaccine, for children aged 6 months to 18 years.
Methods: Two decision-analytic models were developed to simulate 4 vaccination strategies. Outcomes included total costs from a societal perspective in 2021, quality-adjusted life-year loss, numbers of outpatient and inpatient cases, and deaths avoided using each strategy. Deterministic and probabilistic sensitivity analyses were performed to examine the uncertainty of model inputs.
Results: For children aged 6 months to 3 years, trivalent inactivated vaccine saved $48 million and avoided a loss of 17,637 quality-adjusted life-years compared with no vaccination. For children aged 3-18 years, quadrivalent inactivated vaccine was cost-effective compared with trivalent inactivated vaccine, with an incremental cost-effectiveness ratio of $32,948.5/quality-adjusted life-year (willingness-to-pay threshold=$37,653/quality-adjusted life-year), which was sensitive to the RR of vaccine effectiveness of quadrivalent inactivated vaccine versus of trivalent inactivated vaccine. When compared with quadrivalent inactivated vaccine, live attenuated influenza vaccine was $1.28 billion more costly but gained an additional 13,560 quality-adjusted life-years; its incremental cost-effectiveness ratio was $123,983.8/quality-adjusted life-year. Live attenuated influenza vaccine would be cost-effective if its vaccine effectiveness was >0.79. Probabilistic sensitivity analysis revealed that quadrivalent inactivated vaccine, trivalent inactivated vaccine, live attenuated influenza vaccine, and no vaccination were cost-effective in 55.94%, 33.09%, 10.97%, and 0% of 10,000 Monte Carlo simulations.
Conclusions: Trivalent inactivated vaccine was cost-effective compared with no vaccination in children aged 6 months to 18 years. Of the 3 vaccination strategies for children aged 3-18 months, quadrivalent inactivated vaccine appears to be the most cost-effective.