Cost-effectiveness of seasonal quadrivalent versus trivalent influenza vaccination in the United States: A dynamic transmission modeling approach

Abstract

Trivalent inactivated influenza vaccines (IIV3s) protect against 2 A strains and one B lineage; quadrivalent versions (IIV4s) protect against an additional B lineage. The objective was to assess projected health and economic outcomes associated with IIV4 versus IIV3 for preventing seasonal influenza in the US. A cost-effectiveness model was developed to interact with a dynamic transmission model. The transmission model tracked vaccination, influenza cases, infection-spreading interactions, and recovery over 10 y (2012–2022). The cost-effectiveness model estimated influenza-related complications, direct and indirect costs (2013–2014 US$), health outcomes, and cost-effectiveness. Inputs were taken from published/public sources or estimated using regression or calibration. Outcomes were discounted at 3% per year. Scenario analyses tested the reliability of the results. Seasonal vaccination with IIV4 versus IIV3 is predicted to reduce annual influenza cases by 1,973,849 (discounted; 2,325,644 undiscounted), resulting in 12–13% fewer cases and influenza-related complications and deaths. These reductions are predicted to translate into 18,485 more quality-adjusted life years (QALYs) accrued annually for IIV4 versus IIV3. Increased vaccine-related costs ($599 million; 5.7%) are predicted to be more than offset by reduced influenza treatment costs ($699 million; 12.2%), resulting in direct medical cost saving annually ($100 million; 0.6%). Including indirect costs, savings with IIV4 are predicted to be $7.1 billion (5.6%). Scenario analyses predict IIV4 to be cost-saving in all scenarios tested apart from low infectivity, where IIV4 is predicted to be cost-effective. In summary, seasonal influenza vaccination in the US with IIV4 versus IIV3 is predicted to improve health outcomes and reduce costs.

Inclusion of Safety-Related Issues in Economic Evaluations for Seasonal Influenza Vaccines: A Systematic Review

“…The majority of the evaluated studies reported their outcomes using CUA [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. Other types of economic evaluation considered were CEAs ( N = 11) [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ], CBA (11 studies) [ 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ], or combining more than one type (10 studies) [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ,…”

Awareness and acceptance of H1N1 vaccination among physicians: Experience of 2017 vaccination campaign

“…In order to prescribe vaccination, physician's knowledge should be regularly updated. [ 17 18 19 20 21 ]…”

Cost-effectiveness analysis of universal influenza vaccination: Application of the susceptible–infectious–complication–recovery model

“…The taxonomy of modeling in economic evaluations of infectious diseases often varies among studies. Although several recent studies have used a static model (Chit et al, 2015;Clements et al, 2014), the use of a dynamic model for the economic evaluation of universal vaccination has increasingly gained attention (Baguelin et al, 2015;Baguelin et al, 2010;Brogan et al, 2016;Lugner et al, 2012;Meeyai et al, 2015;Pitman et al, 2013;Thommes et al, 2015). The static model is usually considered a conservative method and may be appropriately applied to interventions that are cost-effective.…”