Cost-effectiveness of the cell-based quadrivalent versus the standard egg-based quadrivalent influenza vaccine in Germany

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Mutations of the H3N2 vaccine strain during the egg-based vaccine manufacturing process partly explain the suboptimal effectiveness of traditional seasonal influenza vaccines. Cell-based influenza vaccines improve antigenic match and vaccine effectiveness by avoiding such egg-adaptation. This study evaluated the public health and economic impact of a cell-based quadrivalent influenza vaccine (QIVc) in adults (18–64 years) compared to the standard egg-based quadrivalent influenza vaccine (QIVe) in the US. The impact of QIVc over QIVe in public health and cost outcomes was estimated using a dynamic age-structured SEIR transmission model, which accounted for four circulating influenza strains [A/H1N1pdm9, A/H3N2, B(Victoria), and B(Yamagata)] and was calibrated on the 2013–2018 influenza seasons. The robustness of the results was assessed in univariate and probabilistic sensitivity analyses. Switching from QIVe to QIVc in 18- to 64-year-olds may prevent 5.7 million symptomatic cases, 1.8 million outpatient visits, 50,000 hospitalizations, and 5453 deaths annually. The switch could save 128,000 Quality-Adjusted Life Years (QALYs) and US $ 845 M in direct costs, resulting in cost-savings in a three-year time horizon analysis. Probabilistic sensitivity analyses confirmed the robustness of the cost-saving result. The analysis shows that QIVc is expected to prevent hospitalizations and deaths, and result in substantial savings in healthcare costs.

Section: Discussionsupporting

confidence: 91%

The Epidemiological and Economic Impact of a Cell-Based Quadrivalent Influenza Vaccine in Adults in the US: A Dynamic Modeling Approach

Nguyễn¹,

Hilsky

Mould-Quevedo

2021

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“…Influenza infections in children and adults <65 years of age account for an estimated annual average economic burden of $1.84 billion in direct medical expenditures and $6.94 billion in indirect costs due to missed school by sick children and missed work by sick adults and the parents and guardians who care for children with influenza [54,55]. The results discussed in this review are part of a broader set of studies that have evaluated the relative vaccine effectiveness and cost effectiveness of IIV4c compared to IIV4e [27,[56][57][58][59]. The use of RWE to assess rVE will remain an important source of data for the timely assessment of current and future seasons.…”

Section: Discussionmentioning

confidence: 99%

Review of Analyses Estimating Relative Vaccine Effectiveness of Cell-Based Quadrivalent Influenza Vaccine in Three Consecutive US Influenza Seasons

Boikos¹,

McGovern

Molrine

et al. 2022

The adaptation of influenza seed viruses in egg culture can result in a variable antigenic vaccine match each season. The cell-based quadrivalent inactivated influenza vaccine (IIV4c) contains viruses grown in mammalian cell lines rather than eggs. IIV4c is not subject to egg-adaptive changes and therefore may offer improved protection relative to egg-based vaccines, depending on the degree of match with circulating influenza viruses. We summarize the relative vaccine effectiveness (rVE) of IIV4c versus egg-based quadrivalent influenza vaccines (IIV4e) to prevent influenza-related medical encounters (IRMEs) from three retrospective observational cohort studies conducted during the 2017–2018, 2018–2019, and 2019–2020 US influenza seasons using the same underlying electronic medical record dataset for all three seasons—with the addition of linked medical claims for the latter two seasons. We identified IRMEs using diagnostic codes specific to influenza disease (ICD J09*-J11*) from the records of over 10 million people. We estimated rVE using propensity score methods adjusting for age, sex, race, ethnicity, geographic location, week of vaccination, and health status. Subgroup analyses included specific age groups. IIV4c consistently had higher relative effectiveness than IIV4e across all seasons assessed, which were characterized by different dominant circulating strains and variable antigenic drift or egg adaptation.

“…We found that vaccination with QIVc would reduce the number of seasonal influenza cases, complications, hospitalizations, and deaths compared to QIVe. Endorsing this evidence, several studies evaluated the cost-effectiveness of QIVc compared to QIVe worldwide and demonstrated similar findings [ 17 , 18 , 19 , 21 ]. This result can be attributed to the fact that cell-based influenza vaccines can be more effective than traditional egg-based influenza vaccines, favoring several populations and clinical and economic outcomes [ 17 ].…”

Section: Discussionmentioning

confidence: 75%

“…The cost-effectiveness of QIVc has been reported for the United States (US) [ 16 , 17 ], Spain [ 18 ], Brazil [ 19 ], the United Kingdom (UK) [ 20 ], and Germany [ 21 ]. In the UK, Kohli et al reported the cost-effectiveness of extending QIVc vaccination regimen from at-risk to low-risk adults between 50 and 64 years of age [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Cell Versus Egg-Based Seasonal Influenza Vaccination in Children and Adults in Argentina

Urueña

Micone

Magneres³

et al. 2022

Background: Quadrivalent cell-based influenza vaccines (QIVc) avoid egg-adaptive mutations and can be more effective than traditional quadrivalent egg-based influenza vaccines (QIVe). This analysis compared the cost-effectiveness of QIVc and QIVe in Argentinian populations < 65 years old from the payer and societal perspectives. Methods: A static decision tree model compared the costs and health benefits of vaccination with QIVc vs. QIVe using a one-year time horizon. The relative vaccine effectiveness of QIVc vs. QIVe was assumed to be 8.1% for children and 11.4% for adults. An alternative high egg-adaptation scenario was also assessed. Model inputs were sourced from Argentina or the international literature. Deterministic and probabilistic sensitivity analyses were performed. Results: Compared to QIVe, QIVc would prevent 17,857 general practitioner visits, 2418 complications, 816 hospitalizations, and 12 deaths per year. From the payers’ perspective, the incremental cost-effectiveness ratio per quality-adjusted life years gained was USD12,214 in the base case and USD2311 in the high egg-adaptation scenario. QIVc was cost-saving from the societal perspective in both scenarios. Conclusions: QIVc in Argentina would be cost-effective relative to QIVe. The potential health benefits and savings would be even higher in high egg-adaptation seasons.