Cost-effectiveness of recombinant influenza vaccine compared with standard dose influenza vaccine in adults 18-64 years of age.

Autor: Nowalk MP; University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh PA, 15261 USA., Smith KJ; University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA, 15261 USA., Raviotta JM; University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh PA, 15261 USA. Electronic address: jraviotta@pitt.edu., Wateska A; University of Pittsburgh School of Medicine, Department of Medicine, Pittsburgh PA, 15261 USA., Zimmerman RK; University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh PA, 15261 USA.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2024 Oct 24; Vol. 42 (24), pp. 126107. Date of Electronic Publication: 2024 Jul 05.
DOI: 10.1016/j.vaccine.2024.07.008
Abstrakt: Background: The Advisory Committee on Immunization Practices (ACIP) uses the Evidence to Recommendations Framework that includes cost-effectiveness analyses (CEA) for determining vaccine recommendations. ACIP's preference for protecting adults ≥ 65 years is enhanced vaccines, including recombinant influenza vaccine (RIV4), adjuvanted or high dose influenza vaccine. Less is known about the CEA of enhanced vaccines for younger adults.
Methods: We used decision analysis modeling from a societal perspective to determine the cost-effectiveness, measured in quality adjusted life years (QALYs), of RIV4 compared with standard dose quadrivalent influenza vaccine (SD-IIV4) in adults 18-64 years old. Model inputs included 2018-2020 vaccine effectiveness (VE) estimates based on medical record data from a large local health system, 2019-2020 national vaccination and influenza epidemic parameters, with costs and population distributions fitted to the season.
Results: Among adults ages 18-64 years, RIV4 cost $94,186/QALY gained, compared to SD-IIV4. Among those 50-64 years old, RIV4 was relatively more cost-effective ($61,329/QALY gained). Cost-effectiveness estimates for 18-64-year-olds were sensitive to the absolute difference in VE between SD-IIV4 and RIV4, among other parameters. Use of RIV4 in 18-64-year-olds would result in fewer cases (669,984), outpatient visits (261,293), hospitalizations (20,046) and deaths (1,018) annually. The majority (59 %; 597 of 1018) of the decreases in deaths occurred in the 50-64-year-olds.
Conclusions: While RIV4 was effective and cost-effective relative to SD-IIV4 for both 50-64-year-old and 18-64-year-old adults, cost-effectiveness was sensitive to small changes in parameters among 18-64-year-olds. Because substantial public health benefits occur with enhanced vaccines, health systems and policy makers may opt for preferential product use in select age/risk groups (e.g., 50-64 year olds) to maximize their cost-benefit ratios.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Jonathan M Raviotta reports financial support was provided by Sanofi Pasteur Inc. Richard K Zimmerman reports a relationship with Sanofi Pasteur Inc that includes: funding grants. Mary Patricia Nowalk reports a relationship with Sanofi Pasteur Inc that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper].
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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