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Cost-effectiveness analysis of quadrivalent influenza vaccination in at-risk adults and the elderly: an updated analysis in the United Kingdom

tetano

Editor, Senior Moderator
J Med Econ. 2015 Apr 23:1-40. [Epub ahead of print]
[h=1]Cost-effectiveness analysis of quadrivalent influenza vaccination in at-risk adults and the elderly: an updated analysis in the United Kingdom.[/h] Meier G[SUP]1[/SUP], Gregg M, Poulsen Nautrup B.
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] To update an earlier evaluation estimating the cost-effectiveness of quadrivalent influenza vaccination (QIV) compared with trivalent influenza vaccination (TIV) in the adult population currently recommended for influenza vaccination in the United Kingdom (UK) (all people aged ≥65 years and people aged 18-64 years with clinical risk conditions).
[h=4]METHODS:[/h] This analysis takes into account updated vaccine prices, reference costs, influenza strain circulation and burden of illness data. A lifetime, multi-cohort, static Markov model was constructed with seven age groups. The model was run in one-year cycles for a lifetime, i.e. until the youngest patients at entry reached the age of 100 years. The base-case analysis was from the perspective of the UK National Health Service, with a secondary analysis from the societal perspective. Costs and benefits were discounted at 3.5%. Herd effects were not included. Inputs were derived from systematic reviews, peer-reviewed articles, and government publications and databases. One-way and probabilistic sensitivity analyses were performed.
[h=4]RESULTS:[/h] In the base-case, QIV would be expected to avoid 1,413,392 influenza cases, 41,780 hospitalisations and 19,906 deaths over the lifetime horizon, compared with TIV. The estimated incremental cost-effectiveness ratio (ICER) was ?14,645 per quality-adjusted life-year (QALY) gained. From the societal perspective, the estimated ICER was ?13,497/QALY. A strategy of vaccinating only people aged ≥65 years had an estimated ICER of ?11,998/QALY. Sensitivity analysis indicated that only two parameters, seasonal variation in influenza B matching and influenza A circulation, had a substantial effect on the ICER. QIV would be likely to be cost-effective compared with TIV in 68% of simulations with a willingness-to-pay threshold of <?20,000/QALY and 87% with a willingness-to-pay threshold of <?30,000/QALY.
[h=4]CONCLUSIONS:[/h] In this updated analysis, QIV was estimated to be cost-effective compared with TIV in the UK.


[h=4]KEYWORDS:[/h] UK; cost-effectiveness; quadrivalent; seasonal influenza; trivalent; vaccination

PMID: 25903831 [PubMed - as supplied by publisher]
 
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