Cost-Effectiveness and Burden of Disease for Adjuvanted Quadrivalent Influenza Vaccines Compared to High-Dose Quadrivalent Influenza Vaccines in Elderly Patients in Spain

Abstract

Influenza is a contagious respiratory disease that causes severe illness and death, particularly in elderly populations. Two enhanced formulations of quadrivalent influenza vaccine (QIV) are available in Spain. Adjuvanted QIV (aQIV) is available for those aged 65+ and high-dose QIV (HD-QIV) for those aged 60+. In this study, we used a health economic model to assess the costs and outcomes associated with using aQIV or HD-QIV in subjects aged 65+. Using aQIV instead of HD-QIV to vaccinate an estimated 5,126,343 elderly people results in reductions of 5405 symptomatic cases, 760 primary care visits, 171 emergency room visits, 442 hospitalizations, and 26 deaths in Spain each year. Life-years (LYs) and quality-adjusted LYs (QALYs) increases by 260 and 206, respectively, each year. Savings from a direct medical payer perspective are EUR 63.6 million, driven by the lower aQIV vaccine price and a minor advantage in effectiveness. From a societal perspective, savings increase to EUR 64.2 million. Results are supported by scenario and sensitivity analyses. When vaccine prices are assumed equal, aQIV remains dominant compared to HD-QIV. Potential savings are estimated at over EUR 61 million in vaccine costs alone. Therefore, aQIV provides a highly cost-effective alternative to HD-QIV for people aged 65+ in Spain.

An Economic Evaluation of the Adjuvanted Quadrivalent Influenza Vaccine Compared with Standard-Dose Quadrivalent Influenza Vaccine in the Spanish Older Adult Population

“…Over the last few decades, vaccination has been a successful public health strategy to prevent various infectious diseases worldwide, effectively helping reduce the burden of vaccine-preventable diseases [1,2]. Influenza is an acute viral infection, highly transmissible, observed around the globe every year, with peak spread during the winter season [3].…”

“…Results from a recent modeling exercise across European settings support using enhanced influenza vaccines for the high-risk population (e.g., elderly patients) [7]. Economic modeling studies in Spanish settings have found cell-based QIVs (QIVc) to be cost-effective compared with traditional egg-based QIVs (QIVe) for adult patients (aged 9-64 years and at high-risk of complications) [8]; furthermore, for individuals aged 65 or older, adjuvanted QIV (aQIV) was cost-saving compared with high-dose (HD)-QIV [3], and adjuvanted trivalent influenza vaccine (aTIV) was found to be cost-effective compared with TIV [9,10].…”

The role of cell-mediated immunity against influenza and its implications for vaccine evaluation

“…CMI was not explored in this study ( 155 ). Other more recent studies have meanwhile demonstrated that adjuvanted QIV could offer a reduction in costs for society by reducing hospital admissions and deaths compared to a high dose QIV ( 156 , 157 ).…”

An Economic Comparison in the Elderly of Adjuvanted Quadrivalent Influenza Vaccine with Recombinant Quadrivalent Influenza Vaccine in Spain

“…None of these studies have addressed cost effectiveness—an important factor in determining the overall value of a new vaccine to a community that helps inform decision-making by policy makers and healthcare providers. Using a modeling methodology established in previous studies [ 16 , 17 , 18 , 19 , 20 ], we recently assessed the cost effectiveness of aQIV and HD-QIV and found that aQIV provided cost savings relative to HD-QIV [ 21 ]. Here, we report the results of a similar modeling analysis conducted to evaluate the cost effectiveness of QIVr relative to aQIV.…”