Abstract

ObjectiveIn Turkey, the prevalence of diabetes is high but the influenza vaccination coverage rate (VCR) is low (9.1% in 2014), despite vaccination being recommended and reimbursed. This study evaluated the cost-effectiveness of increasing the influenza VCR of adults with type 2 diabetes in Turkey to 20%.MethodsA decision-analytic model was adapted to Turkey using data derived from published sources. Direct medical costs and indirect costs due to productivity loss were included in the societal perspective. The time horizon was set at 1 year to reflect the seasonality of influenza.ResultsIncreasing the VCR for adults with type 2 diabetes to 20% is predicted to avert an additional 19,777 influenza cases, 2376 hospitalizations, and 236 deaths. Associated influenza costs avoided were estimated at more than 8.3 million Turkish Lira (TRY), while the cost of vaccination would be more than TRY 8.4 million. The incremental cost-effectiveness ratio was estimated at TRY 64/quality-adjusted life years, which is below the per capita gross domestic product of TRY 21,511 and therefore very cost-effective according to World Health Organization guidelines. Factors most influencing the incremental cost-effectiveness ratio were the excess hospitalization rate, inpatient cost, vaccine effectiveness against hospitalization, and influenza attack rate. Increasing the VCR to >20% was also estimated to be very cost-effective.ConclusionsIncreasing the VCR for adults with type 2 diabetes in Turkey to ≥20% would be very cost-effective.

Highlights

  • Influenza is a frequent, serious infectious disease that can lead to severe illness, hospitalization, and death [1]

  • The incremental cost-effectiveness ratio was estimated at TRY 64/quality-adjusted life years, which is below the per capita gross domestic product of TRY 21,511 and very cost-effective according to World Health Organization guidelines

  • World Health Organization (WHO) recommendations are a vaccination coverage rate (VCR) of at least 75% for patients with diabetes, we considered such an increase from the current situation of 9.1% VCR to be unattainable in the immediate future

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Summary

Objective

In Turkey, the prevalence of diabetes is high but the influenza vaccination coverage rate (VCR) is low (9.1% in 2014), despite vaccination being recommended and reimbursed. Editor: Ray Borrow, Public Health England, UNITED KINGDOM Received: January 13, 2016 Accepted: June 2, 2016 Published: June 20, 2016

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