tetano
Editor, Senior Moderator
J Med Econ
. 2023 Mar 24;1-30.
doi: 10.1080/13696998.2023.2194193. Online ahead of print.
Cost-effectiveness of influenza vaccination with a high dose quadrivalent vaccine of the elderly population in Belgium, Finland, and Portugal
Fabián P Alvarez[SUP] 1 [/SUP], Pierre Chevalier[SUP] 2 [/SUP], Matthias Borms[SUP] 2 [/SUP], Hélène Bricout[SUP] 1 [/SUP], Catia Marques[SUP] 3 [/SUP], Anu Soininen[SUP] 4 [/SUP], Tatu Sainio[SUP] 5 [/SUP], Christine Petit[SUP] 6 [/SUP], Caroline de Courville[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Seasonal influenza may result in severe outcomes, resulting in a significant increase of hospitalizations during the winter. To improve the protection provided by the standard dose influenza quadrivalent vaccine (SDQIV), a high-dose vaccine (HDQIV) has been developed specifically for adults aged 60 and older who are at higher risk of life-threatening complications.
Objectives: The aim of this study was to determine the cost-effectiveness of HD QIV vs SD-QIV in the recommended population of three European countries: Belgium, Finland and Portugal.
Methods: A cost-utility analysis comparing HDQIV versus SDQIV was conducted using a decision tree estimating health outcomes conditional on influenza: cases, general practitioner and emergency department visits, hospitalizations and deaths. To account for the full benefit of the vaccine, an additional outcome - hospitalizations attributable to influenza - was also evaluated. Demographic, epidemiological and economic inputs were based on the respective local data. HDQIV relative vaccine efficacy versus SDQIV was obtained from a phase IV efficacy randomized clinical trial. The incremental cost-effectiveness ratios (ICER) were computed for each country, and a probabilistic sensitivity analysis (1,000 simulations per country) was performed to assess the robustness of the results.
Results: In the base case analysis, HDQIV resulted in improved health outcomes (visits, hospitalisations and deaths) compared to SDQIV. The ICERs computed were 1,397 €/QALY, 9,581 €/QALY and 15,267 €/QALY, whereas the PSA yielded 100%, 100% and 84% of simulations being cost-effective at their respective willingness-to-pay thresholds, for Belgium, Finland, and Portugal respectively.
Conclusion: In three European countries with different healthcare systems, HD-QIV would contribute to a significant improvement in the prevention of influenza health outcomes while being cost-effective.
Keywords: Belgium; D; D6; D61; Finland; High-dose influenza vaccine; I; I1; I18; Portugal; cost effectiveness analysis; influenza vaccination; older adults.
. 2023 Mar 24;1-30.
doi: 10.1080/13696998.2023.2194193. Online ahead of print.
Cost-effectiveness of influenza vaccination with a high dose quadrivalent vaccine of the elderly population in Belgium, Finland, and Portugal
Fabián P Alvarez[SUP] 1 [/SUP], Pierre Chevalier[SUP] 2 [/SUP], Matthias Borms[SUP] 2 [/SUP], Hélène Bricout[SUP] 1 [/SUP], Catia Marques[SUP] 3 [/SUP], Anu Soininen[SUP] 4 [/SUP], Tatu Sainio[SUP] 5 [/SUP], Christine Petit[SUP] 6 [/SUP], Caroline de Courville[SUP] 1 [/SUP]
Affiliations
- PMID: 36960689
- DOI: 10.1080/13696998.2023.2194193
Abstract
Background: Seasonal influenza may result in severe outcomes, resulting in a significant increase of hospitalizations during the winter. To improve the protection provided by the standard dose influenza quadrivalent vaccine (SDQIV), a high-dose vaccine (HDQIV) has been developed specifically for adults aged 60 and older who are at higher risk of life-threatening complications.
Objectives: The aim of this study was to determine the cost-effectiveness of HD QIV vs SD-QIV in the recommended population of three European countries: Belgium, Finland and Portugal.
Methods: A cost-utility analysis comparing HDQIV versus SDQIV was conducted using a decision tree estimating health outcomes conditional on influenza: cases, general practitioner and emergency department visits, hospitalizations and deaths. To account for the full benefit of the vaccine, an additional outcome - hospitalizations attributable to influenza - was also evaluated. Demographic, epidemiological and economic inputs were based on the respective local data. HDQIV relative vaccine efficacy versus SDQIV was obtained from a phase IV efficacy randomized clinical trial. The incremental cost-effectiveness ratios (ICER) were computed for each country, and a probabilistic sensitivity analysis (1,000 simulations per country) was performed to assess the robustness of the results.
Results: In the base case analysis, HDQIV resulted in improved health outcomes (visits, hospitalisations and deaths) compared to SDQIV. The ICERs computed were 1,397 €/QALY, 9,581 €/QALY and 15,267 €/QALY, whereas the PSA yielded 100%, 100% and 84% of simulations being cost-effective at their respective willingness-to-pay thresholds, for Belgium, Finland, and Portugal respectively.
Conclusion: In three European countries with different healthcare systems, HD-QIV would contribute to a significant improvement in the prevention of influenza health outcomes while being cost-effective.
Keywords: Belgium; D; D6; D61; Finland; High-dose influenza vaccine; I; I1; I18; Portugal; cost effectiveness analysis; influenza vaccination; older adults.