A systematic review of the health economic consequences of quadrivalent influenza vaccination

Abstract

International audienceBackground: Quadrivalent influenza vaccines (QIVs) contain antigens derived from an additional influenza type B virus as compared with currently used trivalent influenza vaccines (TIVs). This should overcome a potential reduced vaccine protection due to mismatches between TIV and circulating B viruses. In this study, we systematically reviewed the available literature on health economic evaluations of switching from TIV to QIV.Areas covered: The databases of Medline and Embase were searched systematically to identify health economic evaluations of QIV versus TIV published before September 2016.A total of sixteen studies were included, thirteen cost-effectiveness analyses and three cost-comparisons.Expert commentary: Published evidence on the cost-effectiveness of QIV suggests that switching from TIV to QIV would be a valuable intervention from both the public health and economic viewpoint. However, more research seems mandatory. Our main recommendations for future research include: 1) more extensive use of dynamic models in order to estimate the full impact of QIV on influenza transmission including indirect effects, 2) improved availability of data on disease outcomes and costs related to influenza type B viruses, and 3) more research on immunogenicity of natural influenza infection and vaccination, with emphasis on cross-reactivity between different influenza B viruses and duration of protection

Public health and economic impact of switching from a trivalent to a quadrivalent inactivated influenza vaccine in Mexico

“…34 Overall, the greatest benefits for the three countries were during the 2010 and 2012 seasons (corresponding to the Mexico 2009/2010 and 2011/2012 seasons), in which QIV was estimated to reduce influenza B cases by 8.2%−23.3% compared with TIV. 34 Consistent with a systematic review of other health-economics studies, 9 the relative benefit and cost savings of QIV were higher in seasons with more influenza B cases and with poor TIV efficacy against the mismatched B strain. In the retrospective model, the public health and economic benefits were also substantial when there were higher rates of influenza-related hospitalizations and GP consultations among the general population.…”

“…In a systematic review of 16 health economic evaluations from high-income countries, replacing TIV with QIV provided considerable health benefits through reducing influenza-related morbidity and mortality within a range of 0.15%−6.5%. 9 In addition, a switch to QIV was estimated to save costs to healthcare systems and society that compensated for a higher unit price of QIV. However, because almost all studies have focused on high-income settings, the public health and economic benefits of QIV in low-and middle-income countries are less clear.…”

Immunogenicity and safety of an egg-based inactivated quadrivalent influenza vaccine (GC3110A) versus two inactivated trivalent influenza vaccines with alternate B strains: A phase Ⅲ randomized clinical trial in adults

“…Based on local epidemiology, vaccine effectiveness, and medical costs, the cost-effectiveness of QIV was assessed in US, Canada, UK, Germany, Spain, Finland, Australia and Hong Kong. 21 Overall, switching the strategy from TIV to QIV was expected to be cost-effective to further reduce the influenza disease burden. However, the cost-effectiveness of QIV versus TIV might be influenced by several key factors, including vaccine price, level of cross-protection of TIV against the mismatched B strain, proportion of influenza B, and mismatch degree of the circulating B lineages against the vaccine strain.…”

Meditation or exercise for preventing acute respiratory infection (MEPARI-2): A randomized controlled trial

“…Comparison to influenza vaccination (flu shots) may help put MEPARI results in perspective. Flu shots are known to reduce influenza, with published estimates of proportional reductions in symptomatic illness, medical visits, and absenteeism ranging from 13% to 70% [58][59][60][61][62]. Magnitude of benefit observed in various trials seems to depend mostly on the annual vaccine match, and the virulence of influenza strains.…”