Cost-effectiveness analysis of different seasonal influenza vaccines in the elderly Italian population

Abstract

ABSRACTIn the perspective of reaching at least 75% influenza vaccination coverage in the elderly and substantial budget constraints, Italian decision makers are facing important challenges in determining an optimal immunization strategy for this growing and particularly vulnerable population. Four different influenza vaccines are currently available for Italian older adults aged 65 years or above, namely trivalent inactivated vaccines (TIVs), MF59-adjuvanted TIV (MF59-TIV), intradermal TIV (ID-TIV) and quadrivalent inactivated vaccines (QIVs). The present study is the first to compare the cost-effectiveness profiles of virtually all possible public health strategies, including the aforementioned four vaccine formulations as well non-vaccination. For this purpose, a decision tree model was built ex novo; the analysis was conducted from the third-payer perspective in the timeframe of one year. All available vaccines were cost-effective compared with non-vaccination. However, MF59-TIV had the most favorable economic profile in the Italian elderly population. Indeed, compared with non-vaccination, it was deemed highly cost-effective with an incremental cost-effectiveness ratio (ICER) of €10,750 per quality-adjusted life year (QALY). The ICER was much lower (€4,527/QALY) when MF59-TIV was directly compared with TIV. ID-TIV and QIV were dominated by MF59-TIV as the former comparators were associated with greater total costs and lower health benefits. Both deterministic and probabilistic sensitivity analyses confirmed robustness of the base case results. From the economic perspective, MF59-TIV should be considered as a preferential choice for Italian older adults aged 65 years or above.

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

“…Furthermore, two potentially eligible studies and five conference abstracts were identified through manual search. A total of 18 studies, corresponding to 13 full papers [31][32][33][34][35][36][37][38][39][40][41][42][43] and 5 conference abstracts [44][45][46][47][48] were included in the qualitative assessment. The whole process of study selection is illustrated in Figure 1.…”

“…The main characteristics of the included studies are reported in Table 1. Most studies (N = 10) were written in English, 31,32,[34][35][36][37][39][40][41]43 while the remaining two in Spanish 38,42 and one in Italian, 33 respectively. All studies were conducted in high-income countries, namely Italy (N = 5), 32,33,36,41,43 the US (N = 3), 34,37,40 Spain (N = 2), 38,42 Canada (N = 2) 35,39 and France (N = 1).…”

“…Most studies (N = 10) were written in English, 31,32,[34][35][36][37][39][40][41]43 while the remaining two in Spanish 38,42 and one in Italian, 33 respectively. All studies were conducted in high-income countries, namely Italy (N = 5), 32,33,36,41,43 the US (N = 3), 34,37,40 Spain (N = 2), 38,42 Canada (N = 2) 35,39 and France (N = 1). 31 Most studies (N = 8) [31][32][33]35,37,[41][42][43] were funded/supported by pharmaceutical companies and/or included industry employees as authors; three studies 34,39,40 were funded/supported by a public body, while the funding source of other two studies 36,38 was not clearly stated.…”

“…All studies were conducted in high-income countries, namely Italy (N = 5), 32,33,36,41,43 the US (N = 3), 34,37,40 Spain (N = 2), 38,42 Canada (N = 2) 35,39 and France (N = 1). 31 Most studies (N = 8) [31][32][33]35,37,[41][42][43] were funded/supported by pharmaceutical companies and/or included industry employees as authors; three studies 34,39,40 were funded/supported by a public body, while the funding source of other two studies 36,38 was not clearly stated. The study population was set to individuals aged 65 years and older in 10 studies, [32][33][34]36,[38][39][40][41][42][43] while in the earliest study 31 it consisted of the elderly at high risk.…”

Influenza Vaccination of Children of Preschool Age in the Russian Federation: Cost-Effectiveness of Quadrivalent Vaccine

“…Снижение продолжительности жизни с учетом качества в случае заболевания гриппом составило при расчете 0,0078 QALY, при заболевании пневмонией -0,01041 QALY [9].…”