A systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union

Abstract

ObjectivesThe Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population. The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU.MethodsElectronic searches of the NHS Economic Evaluation, Health Technology Assessment, MEDLINE and Embase databases were run to identify full economic evaluations. Two levels of screening were used, with explicit inclusion criteria applied by two independent reviewers at each stage. Prespecified data extraction and critical appraisal were performed on identified studies. Results were summarised qualitatively.ResultsOf the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics.ConclusionsMost studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates.

Use of adjuvanted trivalent influenza vaccine in older-age adults: a systematic review of economic evidence

“…The automatic search strategy was adapted from previous systematic reviews on aTIV 24,25 and those on economic evaluations of influenza vaccines 13,18 and is reported in Supplementary file 1. Medline via Ovid, Embase, Database of Abstracts of Reviews of Effects (DARE) and the NHS Economic Evaluation Database (EED) were the primary information sources.…”

“…12 It is now widely acknowledged that annual influenza vaccination is a good value for money; this has been demonstrated in several systematic reviews of economic studies. [13][14][15] It is particularly cost-effective/cost-saving in the elderly; 13 indeed, seniors are the main internationally recognized target group for annual immunization campaigns. 1,16 Systematic reviews of economic evaluations are becoming increasingly common.…”

“…Considering the above, the present study aimed at systematically assessing the available pharmacoeconomic evidence behind the use of aTIV in the elderly population; indeed, among the three aforementioned elderly-specific vaccines, aTIV was licensed first in 1997, 12 but no comprehensive reviews have been conducted so far. The published systematic evidence [13][14][15] suggests that influenza vaccination is costeffective/cost-saving in the elderly but it is unclear which of the different available alternatives 7 has the most favorable economic profile. Available systematic reviews on economic assessments of influenza vaccination programs have included a few studies 13,15 that specifically addressed aTIV or other elderly-specific vaccines.…”

“…The published systematic evidence [13][14][15] suggests that influenza vaccination is costeffective/cost-saving in the elderly but it is unclear which of the different available alternatives 7 has the most favorable economic profile. Available systematic reviews on economic assessments of influenza vaccination programs have included a few studies 13,15 that specifically addressed aTIV or other elderly-specific vaccines. We, however, hypothesized a larger pool of available evidence on the cost-effectiveness of aTIV, given that it has been on the market over the last 20 years.…”

Cost-Effectiveness Analysis for Influenza Vaccination Coverage and Timing in Tropical and Subtropical Climate Settings: A Modeling Study

“…Evidence of the cost-effectiveness and benefits from influenza vaccination is ample across the literature, but the focus has been on countries with strong seasonality and therefore distinct influenza seasons, which is usually countries in which winter occurs. For example, Shields et al 4 performed a systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union and found that most studies showed that vaccination is cost-effective. Other analyses have assessed whether quadrivalent vaccines are costeffective.…”