Cost-Effectiveness of Influenza Vaccination Strategies in Adults: Older Adults Aged ≥65 Years, Adults Aged 50-64 Years, and At-Risk Adults Aged 19-64 Years.

Min Joo Choi,Won Suk Choi,Jae-Ok Lim,Sang-Eun Choi,Jae-Won Yun,Daewon Kang,Ji Yun Noh,Hee Jin Cheong,Yun-Kyung Kim,Gyeongseon Shin,Woo Joo Kim,Joon Young Song

doi:10.3390/vaccines10030445

Abstract

The high disease burden of influenza in elderly and chronically ill adults may be due to the suboptimal effectiveness and mismatch of the conventional trivalent influenza vaccine (TIV). This study evaluated the cost-effectiveness of quadrivalent (QIV), adjuvanted trivalent (ATIV), and high-dose quadrivalent (HD-QIV) vaccines versus TIV used under the current Korean National Immunization Program (NIP) in older adults aged ≥65 years. We also evaluated the cost-effectiveness of programs for at-risk adults aged 19–64 and adults aged 50–64. A one-year static population model was used to compare the costs and outcomes of alternative vaccination programs in each targeted group. Influenza-related parameters were derived from the National Health Insurance System claims database; other inputs were extracted from the published literature. Incremental cost-effectiveness ratios (ICERs) were assessed from a societal perspective. In the base case analysis (older adults aged ≥65 years), HD-QIV was superior, with the lowest cost and highest utility. Compared with TIV, ATIV was cost-effective (ICER $34,314/quality-adjusted life-year [QALY]), and QIV was not cost-effective (ICER $46,486/QALY). The cost-effectiveness of HD-QIV was robust for all parameters except for vaccine cost. The introduction of the influenza NIP was cost-effective or even cost-saving for the remaining targeted gr3oups, regardless of TIV or QIV.

Highlights

Many consider influenza a mild, self-limiting viral illness, it represents a serious public health problem because of the accompanying pneumonia and high mortality among the at-risk population [1]
In the base case analysis, HD-quadrivalent influenza vaccine (QIV) is expected to be a superior strategy compared to all alternatives, with the lowest cost and highest utility
The results showed that high-dose quadrivalent (HD-QIV) had the most favorable cost-effectiveness profile among all existing commercially available alternatives for older adults, based on currently available data

Summary

Introduction

Many consider influenza a mild, self-limiting viral illness, it represents a serious public health problem because of the accompanying pneumonia and high mortality among the at-risk population [1]. It can cause a considerable socioeconomic impact through reduced workplace productivity and absenteeism during the infection epidemic [2]. Annual influenza vaccination is the most effective strategy to reduce the burden of influenza For this reason, virtually all industrialized and many developing countries recommend annual vaccinations for high-risk populations [3–6]. The main strategies differ slightly from country to country, but most nations recommend influenza vaccination for older adults, young children, pregnant women, and chronically ill patients with high priority. Some countries provide vaccines free of charge to those aged ≥50 years by expanding the age range of older adults [3–7], while others preferentially encourage vaccination of school-age children because of their role in disease transmission [4,5,7]

Methods

Results

Conclusion