Effects of Adverse Events on the Projected Population Benefits and Cost-effectiveness of Using Live Attenuated Influenza Vaccine in Children Aged 6 Months to 4 Years

Abstract

To evaluate the effect of adverse events associated with live attenuated influenza vaccine (LAIV) in children younger than 5 years on the cost-effectiveness of influenza vaccination.Design: A decision analytic model was developed to predict costs and health effects of no vaccination, vaccination with LAIV, and vaccination with inactivated influenza vaccine (IIV). Probabilities, costs, and quality adjustments for uncomplicated influenza, outpatient visits, hospitalizations, deaths, vaccination, and vaccine adverse events were based on primary and published data. The analysis included the possible increased incidence of adverse events following vaccination with LAIV for children younger than 5 years, including fever, wheezing, and hospitalization. A societal perspective was used. Sensitivity analyses, including probabilistic sensitivity analysis, were conducted.Setting: Vaccination in the physician office setting in the United States.Participants: Hypothetical cohorts of healthy children aged 6 months to 4 years.Intervention: Vaccination with LAIV or IIV.Main Outcome Measure: Incremental cost-effectiveness ratio in dollars per quality-adjusted life-year (QALY).

Costs, consequences, and cost‐effectiveness of strategies for Babesia microti donor screening of the US blood supply

“…To permit calculation of QALYs, we estimated preference weights based on reported symptoms. For example, persons with mild and moderate clinical babesiosis typically report having flu‐like symptoms; therefore, we applied the health state utilities associated with “flu” to our model . We used a utility of 0.85 for mild infection and 0.8 for moderate infection.…”

“…For example, persons with mild and moderate clinical babesiosis typically report having flu-like symptoms; 6,7 therefore, we applied the health state utilities associated with "flu" to our model. 35,36 We used a utility of 0.85 for mild infection and 0.8 for moderate infection. We developed a composite health state utility for severe infection based on symptoms typically reported in severe babesiosis coupled with their relative frequency.…”

Estimating Effect of Antiviral Drug Use during Pandemic (H1N1) 2009 Outbreak, United States

“…Reduced demand will also reduce costs of hospitalizations. Assuming a cost per influenza-related hospitalization of US$5,000–$7,000 per patient admitted (adjusted to 2009 dollars) (22–26), averted hospitalizations saved ≈$42 million to $88 million (based on median values of hospitalizations averted; Table 4). A detailed cost-effectiveness analysis, including an in-depth consideration of the costs of hospitalizing pandemic (H1N1) 2009 patients, is the subject of a separate analysis.…”

Vaccination of children with a live-attenuated, intranasal influenza vaccine – analysis and evaluation through a Health Technology Assessment

“…A number of studies assess the use of LAIV as a cost-saving or cost-effective intervention [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43], [44], [45], [46], [47]. However, not all studies reach consistent results.…”