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The cost-effectiveness of trivalent and quadrivalent influenza vaccination in communities in South Africa, Vietnam and Australia

tetano

Editor, Senior Moderator
Vaccine. 2018 Jan 17. pii: S0264-410X(17)31836-4. doi: 10.1016/j.vaccine.2017.12.073. [Epub ahead of print]
[h=1]The cost-effectiveness of trivalent and quadrivalent influenza vaccination in communities in South Africa, Vietnam and Australia.[/h] de Boer PT[SUP]1[/SUP], Kelso JK[SUP]2[/SUP], Halder N[SUP]3[/SUP], Nguyen TP[SUP]4[/SUP], Moyes J[SUP]5[/SUP], Cohen C[SUP]6[/SUP], Barr IG[SUP]7[/SUP], Postma MJ[SUP]8[/SUP], Milne GJ[SUP]9[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] To inform national healthcare authorities whether quadrivalent influenza vaccines (QIVs) provide better value for money than trivalent influenza vaccines (TIVs), we assessed the cost-effectiveness of TIV and QIV in low-and-middle income communities based in South Africa and Vietnam and contrasted these findings with those from a high-income community in Australia.
[h=4]METHODS:[/h] Individual based dynamic simulation models were interfaced with a health economic analysis model to estimate the cost-effectiveness of vaccinating 15% of the population with QIV or TIV in each community over the period 2003-2013. Vaccination was prioritized for HIV-infected individuals, before elderly aged 65+ years and young children. Country or region-specific data on influenza-strain circulation, clinical outcomes and costs were obtained from published sources. The societal perspective was used and outcomes were expressed in International$ (I$) per quality-adjusted life-year (QALY) gained.
[h=4]RESULTS:[/h] When compared with TIV, we found that QIV would provide a greater reduction in influenza-related morbidity in communities in South Africa and Vietnam as compared with Australia. The incremental cost-effectiveness ratio of QIV versus TIV was estimated at I$4183/QALY in South Africa, I$1505/QALY in Vietnam and I$80,966/QALY in Australia.
[h=4]CONCLUSIONS:[/h] The cost-effectiveness of QIV varied between communities due to differences in influenza epidemiology, comorbidities, and unit costs. Whether TIV or QIV is the most cost-effective alternative heavily depends on influenza B burden among subpopulations targeted forvaccination in addition to country-specific willingness-to-pay thresholds and budgetary impact.
Copyright ? 2017. Published by Elsevier Ltd.


[h=4]KEYWORDS:[/h] Cost-effectiveness; Dynamic transmission model; Influenza; Quadrivalent; Trivalent; Vaccination

PMID: 29373192 DOI: 10.1016/j.vaccine.2017.12.073
 
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