Cost-effectiveness of quadrivalent versus trivalent influenza vaccine for elderly population in China

Jiang, Minghuan; Li, Pengchao; Wang, Weihua; Zhao, Mingyue; Atif, Naveel; Zhu, Siyu; Fang, Yu

doi:10.1016/j.vaccine.2019.11.045

Cited by 24 publications

(30 citation statements)

References 22 publications

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“…Only two studies to date has assessed the costeffectiveness of influenza vaccination among older adults in China [53,54]. The study of Chen et al [53] had a number of limitations: (i) it used influenza-related outpatient and hospitalization rates in the USA, which may not be good proxies for relevant rates in China due to the different influenza seasonality, virus activity, health-seeking behavior, etc.…”

Section: Discussionmentioning

confidence: 99%

“…With these shortcomings, the paper suggested that government-funded influenza vaccination was < 50% likely to be cost-effective, when compared to a threshold of one times GDP per capita. Similarly, the second study used the influenza-related burden in a few developed cities like Beijing and Shanghai [54]. In our study, we used the most recent China-specific post-2009 pandemic data stratified by provinces, including influenzarelated outpatient, hospitalization, and mortality rates.…”

Section: Discussionmentioning

confidence: 99%

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Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis

Yang

Atkins

Feng

et al. 2020

BMC Med

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Background: China has an aging population with an increasing number of adults aged ≥ 60 years. Influenza causes a heavy disease burden in older adults, but can be alleviated by vaccination. We assessed the cost-effectiveness of a potential government-funded seasonal influenza vaccination program in older adults in China. Methods: We characterized the health and economic impact of a fully funded influenza vaccination program for older adults using China-specific influenza disease burden, and related cost data, etc. Using a decision tree model, we calculated the incremental costs per quality-adjusted life year (QALY) gained of vaccination from the societal perspective, at a willingness-to-pay threshold equivalent to GDP per capita (US$8840). Moreover, we estimated the threshold vaccination costs, under which the fully funded vaccination program is cost-effective using GDP per capita as the willingness-to-pay threshold. Results: Compared to current self-paid vaccination, a fully funded vaccination program is expected to prevent 19, 812 (95% uncertainty interval, 7150-35,783) influenza-like-illness outpatient consultations per year, 9418 (3386-17, 068) severe acute respiratory infection hospitalizations per year, and 8800 (5300-11,667) respiratory excess deaths due to influenza per year, and gain 70,212 (42,106-93,635) QALYs per year. Nationally, the incremental costs per QALY gained of the vaccination program is US$4832 (3460-8307), with a 98% probability of being cost-effective. The threshold vaccination cost is US$10.19 (6.08-13.65). However, variations exist between geographical regions, with Northeast and Central China having lower probabilities of cost-effectiveness. Conclusions: Our results support the implementation of a government fully funded older adult vaccination program in China. The regional analysis provides results across settings that may be relevant to other countries with similar disease burden and economic status, especially for low-and middle-income countries where such analysis is limited.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis

Yang

Atkins

Feng

et al. 2020

BMC Med

View full text Add to dashboard Cite

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“…Moreover, since vaccination is currently the most effective way to prevent influenza infection, a quadrivalent influenza vaccine appears to be a cost-effective option for high-risk groups such as the elderly compared to a trivalent influenza vaccine (Jiang et al, 2020;Ye et al, 2019;Zhao et al, 2015). Therefore, comparative assessment of the impact of influenza B lineages with other subtypes on mortality from various underlying diseases can provide evidence for government departments that may undertake more effective strategies to increase the coverage of quadrivalent vaccination for specific populations to curb the disease burden of influenza.…”

Section: Introductionmentioning

confidence: 99%

Age- and sex-specific excess mortality associated with influenza in Shanghai, China, 2010–2015

Jin

Cai

et al. 2020

International Journal of Infectious Diseases

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Few studies have explored the different lineages of influenza B viruses, which cause excessive fatalities. This study aimed to estimate age-and sex-specific excessive mortality associated with influenza subtypes/lineages in Shanghai, during 2010-2015. Methods: We used quasi-Poisson regression models to fit weekly numbers of deaths from various causes by adjusting long-term trend, seasonal trend, and absolute humidity as confounding factors. The mortality burden associated with influenza subtypes/lineages was estimated by age and sex. Results: The average influenza-associated excessive mortality rate in deaths coded as all-cause was 27.66 (95%CI: 22.30-33.88) per 100,000 person-years. The excessive deaths from six underlying causes in people aged !65 years weight heavily. Compared to influenza B(Victoria) lineage, influenza B(Yamagata) lineage had more effect on the influenza-associated disease burden, particularly in patients with respiratory and circulatory diseases. There was no statistical significance of sex in the mortality burden associated with influenza. Conclusion: Disproportionate mortality associated with influenza B virus is dominated by B(Yamagata) lineage in Shanghai, and the evidence for sex differences in the influenza-associated mortality burden for respiratory and circulatory diseases is limited. Improving the vaccination of the elderly and strengthening laboratory-based surveillance of influenza B lineages in Shanghai are needed to reduce this influenza's disease burden.

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“…Consequently PPSV-23 in the high age group may cost less and gain more QALY. One study has shown that influenza vaccination in 69-year-old people was economical ( 30 ). Pneumonia, influenza, and other lower respiratory infectious diseases are the only diseases that can be prevented by vaccines among the top 10 of the disease financial burden of the elderly in China ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of 23-Valent Pneumococcal Polysaccharide Vaccine Program for the Elderly Aged 60 Years or Older in Shanghai, China

Sun

Tang

et al. 2021

Front. Public Health

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Background: The pneumococcal vaccine has been considered as the most effective measure to prevent pneumococcal diseases. In 2013, Shanghai launched a major public health program to vaccinate people aged 60 years or older with 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV-23) free of charge. By the end of June 2020, a total of 1.56 million old people had been vaccinated free of charge.Objective: To evaluate the cost-effectiveness of PPSV-23 vaccination program in Shanghai from the health system perspective.Methods: According to the actual number of people aged 60 years or older with PPSV-23 vaccination in Shanghai from 2013 to 2018, a multi-cohort Markov model for life-time was developed to compare health and economic outcomes of vaccinated people vs. if they were not vaccinated for PPSV-23. Cost effectiveness was reported as incremental cost effectiveness ratio (ICER). A 5% discount rate was used for both costs and health outcomes. In addition, one-way sensitivity analysis was used to test the model's robustness.Results: By the end of 2018, a total of 1,091,967 people aged 60 years or older were vaccinated with PPSV-23 in Shanghai, China. Comparing with the unvaccinated circumstances, PPSV-23 vaccination would cost US $19.62 million more and receive an additional 10,321.3 quality-adjusted life-year (QALY). PPSV-23 was associated with the ICER of $190.1 per QALY gained. The Results were sensitive to the variation of vaccine effectiveness against community-acquired pneumonia (CAP), and disease incidence, mortality, and costs of CAP. In all sensitivity analysis, the PPSV-23 was economical.Conclusion: The PPSV-23 vaccination program in Shanghai was cost-effective. With the further development of the project, the administrative costs of the vaccine will be reduced, making it more cost-effective.

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Cost-effectiveness of quadrivalent versus trivalent influenza vaccine for elderly population in China

Cited by 24 publications

References 22 publications

Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis

Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis

Age- and sex-specific excess mortality associated with influenza in Shanghai, China, 2010–2015

Cost-Effectiveness Analysis of 23-Valent Pneumococcal Polysaccharide Vaccine Program for the Elderly Aged 60 Years or Older in Shanghai, China

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