Impact of quadrivalent influenza vaccines in Brazil: a cost-effectiveness analysis using an influenza transmission model

Crépey, Pascal; Boiron, L.; Araujo, Rafael Rodrigo; López, Juan Guillermo; Petitjean, Audrey; Luna, Expedito José de Albuquerque

doi:10.1186/s12889-020-09409-7

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…The impact of replacing the TIV by QIV in a pediatric group has been estimated. When the dynamic epidemiological model was applied to the Brazilian context, QIV adoption would be able to avoid 406,600 symptomatic cases, 11,300 hospitalizations, and almost 400 deaths per influenza season, reinforcing the cost-effectiveness of QIV and its respective public health benefits [ 58 , 59 , 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Vaccine Mismatches, Viral Circulation, and Clinical Severity Patterns of Influenza B Victoria and Yamagata Infections in Brazil over the Decade 2010–2020: A Statistical and Phylogeny–Trait Analyses

Costa

Siqueira

Brown

et al. 2022

Viruses

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Worldwide, infections by influenza viruses are considered a major public health challenge. In this study, influenza B vaccine mismatches and clinical aspects of Victoria and Yamagata infections in Brazil were assessed. Clinical samples were collected from patients suspected of influenza infection. In addition, sociodemographic, clinical, and epidemiological information were collected by the epidemiological surveillance teams. Influenza B lineages were determined by real-time RT-PCR and/or Sanger sequencing. In addition, putative phylogeny–trait associations were assessed by using the BaTS program after phylogenetic reconstruction by a Bayesian Markov Chain Monte Carlo method (BEAST software package). Over 2010–2020, B/Victoria and B/Yamagata-like lineages co-circulated in almost all seasonal epidemics, with B/Victoria predominance in most years. Vaccine mismatches between circulating viruses and the trivalent vaccine strains occurred in five of the eleven seasons (45.5%). No significant differences were identified in clinical presentation or disease severity caused by both strains, but subjects infected by B/Victoria-like viruses were significantly younger than their B/Yamagata-like counterparts (16.7 vs. 31.4 years, p < 0.001). This study contributes to a better understanding of the circulation patterns and clinical outcomes of B/Victoria- and B/Yamagata-like lineages in Brazil and advocate for the inclusion of a quadrivalent vaccine in the scope of the Brazilian National Immunization Program.

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Section: Discussionmentioning

confidence: 99%

Vaccine Mismatches, Viral Circulation, and Clinical Severity Patterns of Influenza B Victoria and Yamagata Infections in Brazil over the Decade 2010–2020: A Statistical and Phylogeny–Trait Analyses

Costa

Siqueira

Brown

et al. 2022

Viruses

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“…Studies from all regions of the world have demonstrated the significant economic benefits of QIV use compared with TIV [ 9 , 10 , 11 , 16 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. Currently in Argentina, the National Immunization Program recommends annual receipt of TIV for individuals classified as “at risk”.…”

Section: Discussionmentioning

confidence: 99%

“…Jamotte et al estimate that the use of QIV in Brazil, Colombia, and Panama would significantly reduce the burden of seasonal influenza disease in these countries [ 8 ]. Studies from Mexico and Brazil have shown that the use of quadrivalent rather than trivalent vaccines in these countries would be cost-effective [ 9 , 10 , 11 ]. These and other data suggest that the introduction of QIV in Argentina could potentially be of benefit.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Switching from Trivalent to Quadrivalent Seasonal Influenza Vaccine in Argentina

Urueña

Micone

Magneres³

et al. 2021

Vaccines

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The burden of seasonal influenza disease in Argentina is considerable. The cost-effectiveness of trivalent (TIV) versus quadrivalent influenza vaccine (QIV) in Argentina was assessed. An age-stratified, static, decision-tree model compared the costs and benefits of vaccination for an average influenza season. Main outcomes included: numbers of influenza cases; general practitioner (GP) visits; complicated ambulatory cases; hospitalizations; deaths averted; and costs per quality-adjusted life years (QALYs) gained. Epidemiological data from Argentina for 2014–2019 were used to determine the proportion of A and B strain cases, and the frequency of mismatch between vaccine and circulating B strains. To manage uncertainty, one-way and probabilistic sensitivity analyses were performed. Switching from TIV to QIV would prevent 19,128 influenza cases, 16,164 GP visits, 2440 complicated ambulatory cases, 524 hospitalizations, and 82 deaths. Incremental cost–effectiveness ratios (ICERs) per QALY were 13,590 and 11,678 USD from the payer’s and societal perspectives, respectively. The greatest health benefits and direct medical cost savings would occur in ≥ 65-year-olds. One-way sensitivity analyses demonstrated the principal drivers of ICER to be vaccine acquisition costs, environmental B strain predominance, and B strain mismatch. Introducing QIV in Argentina would be beneficial and cost-effective relative to TIV, particularly in older adults.

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“…Even allowing for this variability, numerous health economic evaluations have suggested that replacing TIV with QIV is cost-effective in eligible populations (generally children ≤4 years of age, adults ≥65 years of age, other adults at high risk of influenza complications, or subgroups of these categories). The switch to QIV has been demonstrated to be cost-effective in a number of local settings around the world, as reported in a systematic review 1 and for several countries, for example Canada, 10 Italy, 11 Germany, 12 Spain, 13 Brazil, 14 China, 15 South Korea, 16 and Japan. 17 Benefits from switching from TIV to QIV have also been demonstrated in a Latin American context, for example in Brazil, Colombia, Panama, and Mexico.…”

Section: Introductionmentioning

confidence: 93%

“… 17 Benefits from switching from TIV to QIV have also been demonstrated in a Latin American context, for example in Brazil, Colombia, Panama, and Mexico. 14 , 18–20 …”

Section: Introductionmentioning

confidence: 99%

Switching from trivalent to quadrivalent inactivated influenza vaccines in Uruguay: a cost-effectiveness analysis

Bianculli

Bellier²,

Mangado³

et al. 2022

Human Vaccines & Immunotherapeutics

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We evaluated the cost-utility of replacing trivalent influenza vaccine (TIV) with quadrivalent influenza vaccine (QIV) in the current target populations in Uruguay. An existing decision-analytic static cost-effectiveness model was adapted for Uruguay. The population was stratified into age groups. Costs and outcomes were estimated for an average influenza season, based on observed rates from 2013 to 2019 inclusive. Introducing QIV instead of TIV in Uruguay would avoid around 740 additional influenza cases, 500 GP consultations, 15 hospitalizations, and three deaths, and save around 300 workdays, for the same vaccination coverage during an average influenza season. Most of the influenza-related consultations and hospitalizations would be avoided among children ≤4 and adults ≥65 years of age. Using QIV rather than TIV would cost an additional ~US$729,000, but this would be partially offset by savings in consultations and hospitalization costs. The incremental cost per quality-adjusted life-year (QALY) gained with QIV would be in the order of US$18,000 for both the payor and societal perspectives, for all age groups, and around US$12,000 for adults ≥65 years of age. The main drivers influencing the incremental cost-effectiveness ratio were the vaccine efficacy against the B strains and the percentage of match each season with the B strain included in TIV. Probabilistic sensitivity analysis showed that switching to QIV would provide a favorable cost-utility ratio for 50% of simulations at a willingness-to-pay per QALY of US$20,000. A switch to QIV is expected to be cost-effective for the current target populations in Uruguay, particularly for older adults.

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Impact of quadrivalent influenza vaccines in Brazil: a cost-effectiveness analysis using an influenza transmission model

Cited by 12 publications

References 21 publications

Vaccine Mismatches, Viral Circulation, and Clinical Severity Patterns of Influenza B Victoria and Yamagata Infections in Brazil over the Decade 2010–2020: A Statistical and Phylogeny–Trait Analyses

Vaccine Mismatches, Viral Circulation, and Clinical Severity Patterns of Influenza B Victoria and Yamagata Infections in Brazil over the Decade 2010–2020: A Statistical and Phylogeny–Trait Analyses

Cost-Effectiveness Analysis of Switching from Trivalent to Quadrivalent Seasonal Influenza Vaccine in Argentina

Switching from trivalent to quadrivalent inactivated influenza vaccines in Uruguay: a cost-effectiveness analysis

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