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Cost-Effectiveness and Public Health Effect of Influenza Vaccine Strategies for U.S. Elderly Adults

tetano

Editor, Senior Moderator
J Am Geriatr Soc. 2016 Oct 6. doi: 10.1111/jgs.14323. [Epub ahead of print]
[h=1]Cost-Effectiveness and Public Health Effect of Influenza Vaccine Strategies for U.S. Elderly Adults.[/h] Raviotta JM[SUP]1[/SUP], Smith KJ[SUP]2[/SUP], DePasse J[SUP]3[/SUP], Brown ST[SUP]3[/SUP], Shim E[SUP]4[/SUP], Nowalk MP[SUP]2[/SUP], Zimmerman RK[SUP]2[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] To compare the cost-effectiveness of four influenza vaccines available in the United States for persons aged 65 and older: trivalent inactivated influenza vaccine (IIV3), quadrivalent inactivated influenza vaccine (IIV4), a more-expensive high-dose IIV3, and a newly approved adjuvanted IIV3.
[h=4]DESIGN:[/h] Cost-effectiveness analysis using a Markov model and sensitivity analyses.
[h=4]SETTING:[/h] A hypothetical influenza vaccination season modeled according to possible U.S. influenza vaccination policies.
[h=4]PARTICIPANTS:[/h] Hypothetical cohort of individuals aged 65 and older in the United States.
[h=4]MEASUREMENTS:[/h] Cost-effectiveness and public health benefits of available influenza vaccination strategies in U.S. elderly adults.
[h=4]RESULTS:[/h] IIV3 cost $3,690 per quality-adjusted life year (QALY) gained, IIV4 cost $20,939 more than IIV3 per QALY gained, and high-dose IIV3 cost $31,214 more per QALY than IIV4. The model projected 83,775 fewer influenza cases and 980 fewer deaths with high-dose IIV3 than with the next most-effective vaccine: IIV4. In a probabilistic sensitivity analysis, high-dose IIV3 was the favored strategy if willingness to pay is $25,000 or more per QALY gained. Adjuvanted IIV3 cost-effectiveness depends on its price and effectiveness (neither yet determined in the United States) but could be favored if its relative effectiveness is 15% greater than that of IIV3.
[h=4]CONCLUSION:[/h] From economic and public health standpoints, high-dose IIV3 for adults aged 65 years and older is likely to be favored over the other vaccines, based on currently available data. The cost-effectiveness of adjuvanted IIV3 should be reviewed after its effectiveness has been compared with that of other vaccines and its U.S. price is established.
? 2016, Copyright the Authors Journal compilation ? 2016, The American Geriatrics Society.


[h=4]KEYWORDS:[/h] cost effectiveness; high-dose IIV3; influenza vaccination

PMID: 27709600 DOI: 10.1111/jgs.14323
[PubMed - as supplied by publisher]
 
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