tetano
Editor, Senior Moderator
Infect Dis Poverty
. 2023 Oct 11;12(1):92.
doi: 10.1186/s40249-023-01144-6. Cost-effectiveness of seasonal influenza vaccination of children in China: a modeling analysis
Qiang Wang[SUP] #[/SUP][SUP] 1 2 [/SUP], Huajie Jin[SUP] #[/SUP][SUP] 3 [/SUP], Liuqing Yang[SUP] #[/SUP][SUP] 1 4 [/SUP], Hui Jin[SUP] #[/SUP][SUP] 5 6 [/SUP], Leesa Lin[SUP] #[/SUP][SUP] 2 7 8 [/SUP]
Affiliations
Background: China has a high burden of influenza-associated illness among children. We aimed to evaluate the cost-effectiveness of introducing government-funded influenza vaccination to children in China (fully-funded policy) compared with the status quo (self-paid policy).
Methods: A decision tree model was developed to calculate the economic and health outcomes, from a societal perspective, using national- and provincial-level data. The incremental cost-effectiveness ratio (ICER) [incremental costs per quality-adjusted life year (QALY) gained] was used to compare the fully-funded policy with the self-paid policy under the willingness-to-pay threshold equivalent to national and provincial GDP per capita. Sensitivity analyses were performed and various scenarios were explored based on real-world conditions, including incorporating indirect effect into the analysis.
Results: Compared to the self-paid policy, implementation of a fully-funded policy could prevent 1,444,768 [95% uncertainty range (UR): 1,203,446-1,719,761] symptomatic cases, 92,110 (95% UR: 66,953-122,226) influenza-related hospitalizations, and 6494 (95% UR: 4590-8962) influenza-related death per season. The fully-funded policy was cost-effective nationally (7964 USD per QALY gained) and provincially for 13 of 31 provincial-level administrative divisions (PLADs). The probability of a funded vaccination policy being cost-effective was 56.5% nationally, and the probability in 9 of 31 PLADs was above 75%. The result was most sensitive to the symptomatic influenza rate among children under 5 years [ICER ranging from - 25,612 (cost-saving) to 14,532 USD per QALY gained]. The ICER of the fully-funded policy was substantially lower (becoming cost-saving) if the indirect effects of vaccination were considered.
Conclusions: Introducing a government-funded influenza policy for children is cost-effective in China nationally and in many PLADs. PLADs with high symptomatic influenza rate and influenza-associated mortality would benefit the most from a government-funded influenza vaccination program.
Keywords: Children; China; Cost-effectiveness analysis; Influenza; Vaccination.
. 2023 Oct 11;12(1):92.
doi: 10.1186/s40249-023-01144-6. Cost-effectiveness of seasonal influenza vaccination of children in China: a modeling analysis
Qiang Wang[SUP] #[/SUP][SUP] 1 2 [/SUP], Huajie Jin[SUP] #[/SUP][SUP] 3 [/SUP], Liuqing Yang[SUP] #[/SUP][SUP] 1 4 [/SUP], Hui Jin[SUP] #[/SUP][SUP] 5 6 [/SUP], Leesa Lin[SUP] #[/SUP][SUP] 2 7 8 [/SUP]
Affiliations
- PMID: 37821942
- PMCID: PMC10566174
- DOI: 10.1186/s40249-023-01144-6
Background: China has a high burden of influenza-associated illness among children. We aimed to evaluate the cost-effectiveness of introducing government-funded influenza vaccination to children in China (fully-funded policy) compared with the status quo (self-paid policy).
Methods: A decision tree model was developed to calculate the economic and health outcomes, from a societal perspective, using national- and provincial-level data. The incremental cost-effectiveness ratio (ICER) [incremental costs per quality-adjusted life year (QALY) gained] was used to compare the fully-funded policy with the self-paid policy under the willingness-to-pay threshold equivalent to national and provincial GDP per capita. Sensitivity analyses were performed and various scenarios were explored based on real-world conditions, including incorporating indirect effect into the analysis.
Results: Compared to the self-paid policy, implementation of a fully-funded policy could prevent 1,444,768 [95% uncertainty range (UR): 1,203,446-1,719,761] symptomatic cases, 92,110 (95% UR: 66,953-122,226) influenza-related hospitalizations, and 6494 (95% UR: 4590-8962) influenza-related death per season. The fully-funded policy was cost-effective nationally (7964 USD per QALY gained) and provincially for 13 of 31 provincial-level administrative divisions (PLADs). The probability of a funded vaccination policy being cost-effective was 56.5% nationally, and the probability in 9 of 31 PLADs was above 75%. The result was most sensitive to the symptomatic influenza rate among children under 5 years [ICER ranging from - 25,612 (cost-saving) to 14,532 USD per QALY gained]. The ICER of the fully-funded policy was substantially lower (becoming cost-saving) if the indirect effects of vaccination were considered.
Conclusions: Introducing a government-funded influenza policy for children is cost-effective in China nationally and in many PLADs. PLADs with high symptomatic influenza rate and influenza-associated mortality would benefit the most from a government-funded influenza vaccination program.
Keywords: Children; China; Cost-effectiveness analysis; Influenza; Vaccination.