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Cost-effectiveness of switching from trivalent to quadrivalent inactivated influenza vaccines for the at-risk population in Italy

tetano

Editor, Senior Moderator
Hum Vaccin Immunother. 2018 Apr 30:0. doi: 10.1080/21645515.2018.1469368. [Epub ahead of print]
[h=1]Cost-effectiveness of switching from trivalent to quadrivalent inactivated influenza vaccines for the at-risk population in Italy.[/h] Mennini FS[SUP]1[/SUP], Bini C[SUP]2[/SUP], Marcellusi A[SUP]3[/SUP], Rinaldi A[SUP]4[/SUP], Franco E[SUP]5[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] Seasonal influenza is caused by two subtypes of influenza A and two lineages of influenza B. Although trivalent influenza vaccines (TIVs) contain both circulating A strains, they contain only a single B-lineage strain. This can lead to mismatches between the vaccine and predominant circulating B lineages, a concern especially for at-risk populations. Quadrivalent influenza vaccines (QIVs) containing a strain from both B lineages have been developed to improve protection against influenza. Here, we used a cost-utility model to examine whether switching from TIV to QIV would be cost-effective for the at-risk population in Italy. Costs were estimated from the payer and societal perspectives. The discount rate for outcomes was 3.0%. Univariate and probabilistic sensitivity analyses were performed to examine the effects of variations in parameters. Switching from TIV to QIV in Italy was estimated to increase quality-adjusted life-years (QALYs) and produce cost savings, including ?1.6 million for hospitalization and approximately ?2 million in productivity. The incremental cost-effectiveness ratio was ?23,426 per QALY from a payer perspective and ?21,096 per QALY from a societal perspective. Switching to QIV was most cost-effective for individuals ≥ 65 years of age (?19,170 per QALY). Probabilistic sensitivity analysis showed that the switching from TIV to QIV would be cost-effective for > 91% of simulation at a maximum willingness-to-pay threshold of ?40,000 per QALY gained. Although the model did not take herd protection into account, it predicted that the switch from TIV to QIV would be cost-effective for the at-risk population in Italy.


[h=4]KEYWORDS:[/h] Italy; chronic disease; cost-benefit analysis; elderly; influenza B; quadrivalent influenza vaccine; quality-adjusted life years

PMID: 29708843 DOI: 10.1080/21645515.2018.1469368
 
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