Cost-effectiveness and budget impact analysis for high dose quadrivalent influenza vaccine in the Italian elderly population
DOI:
https://doi.org/10.33393/grhta.2021.2247Keywords:
Cost-Effectiveness Analysis , Economic evaluation, Influenza, VaccinesAbstract
Introduction. Influenza is a widespread acute respiratory disease and represents a serious Public Health problem, both from the NHS and society perspectives. The High Dose quadrivalent influenza vaccine (QIV HD) is a flu vaccine containing 4 times the antigens of a Standard Dose vaccine, resulting in demonstrated superior protection in the population aged 65 years and over.
Methods. The analysis has been conducted from the perspective of the NHS. The CEA focuses on the comparison between QIV HD and the QIV SD vaccine. The BIM aims to estimate the potential economic impact for the National Health Service (NHS) resulting from the use of QIV HD in clinical practice in subjects aged 65 or over, when considering its introduction in combination with currently used vaccines, QIV SD and adjuvanted TIV.
Results. In a scenario which considers hospitalizations possibly related to influenza, so including cardio-respiratory events, a dominant cost-effectiveness profile emerges in the comparison with QIV SD. In terms of budget impact, overall savings obtained by comparing the two scenarios regarding hospitalizations are equal to 92,766,429 € over the three years’ time horizon considered in the analysis.
Conclusions. Nowadays, also considering the state of emergency due to the spread of the SARS-CoV-2 virus, it is crucial to implement innovative health technologies that improve the efficiency and sustainability of the health system. Also, it is essential to protect the elderly population, helping to avoid overload and healthcare systems disruption due to the many COVID-19 hospitalizations.
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References
Zhou B, Wentworth DE. Influenza A virus molecular virology techniques. Methods Mol Biol. 2012;865:175-192. https://doi.org/10.1007/978-1-61779-621-0_11 PMID:22528160 DOI: https://doi.org/10.1007/978-1-61779-621-0_11
Bertolani A, Fattore G, Pregliasco F. The hospitalization burden of influenza: just the tip of the iceberg? Global & Regional Health Technology Assessment. 2018;1-9. https://doi.org/10.1177/2284240318777148 DOI: https://doi.org/10.1177/2284240318777148
Thompson WW, Shay DK, Weintraub E, et al. Influenza-associated hospitalizations in the United States. JAMA. 2004;292(11):1333-1340. https://doi.org/10.1001/jama.292.11.1333PMID:15367555 DOI: https://doi.org/10.1001/jama.292.11.1333
Hollingsworth R, Palmu A, Pepin S, et al. Effectiveness of the quadrivalent high-dose influenza vaccine for prevention of cardiovascular and respiratory events in people aged 65 years and above: rationale and design of a real-world pragmatic randomized clinical trial. Am Heart J. 2021;237:54-61. https://doi.org/10.1016/j.ahj.2021.03.007 PMID:33722585 DOI: https://doi.org/10.1016/j.ahj.2021.03.007
DiazGranados CA, Dunning AJ, Kimmel M, et al. Efficacy of high-dose versus standard-dose influenza vaccine in older adults. N Engl J Med. 2014;371(7):635-645. https://doi.org/10.1056/NEJMoa1315727 PMID:25119609 DOI: https://doi.org/10.1056/NEJMoa1315727
Lee JKH, Lam GKL, Shin T, et al. Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis. Expert Rev Vaccines. 2018;17(5):435-443. https://doi.org/10.1080/14760584.2018.1471989 PMID:29715054 DOI: https://doi.org/10.1080/14760584.2018.1471989
Istituto Nazionale di Statistica – disponibile su: https://www.istat.it/; Popolazione residente al 1° gennaio; (ultimo accesso aprile 2021)
Dati coperture vaccinali. Ministero della Salute. Online http://www.salute.gov.it/portale/vaccinazioni/dettaglioContenutiVaccinazioni.jsp?lingua=italiano&id=811&area=vaccinazioni&menu=vuoto; (ultimo accesso aprile 2021)
Somes MP, Turner RM, Dwyer LJ, Newall AT. Estimating the annual attack rate of seasonal influenza among unvaccinated individuals: A systematic review and meta-analysis. Vaccine. 2018;36(23):3199-3207. https://doi.org/10.1016/j.vaccine.2018.04.063 PMID:29716771 DOI: https://doi.org/10.1016/j.vaccine.2018.04.063
Trucchi C, Paganino C, Orsi A, et al. Hospital and economic burden of influenza-like illness and lower respiratory tract infection in adults ≥50 years-old. BMC Health Serv Res. 2019;19(1):585. https://doi.org/10.1186/s12913-019-4412-7 PMID:31426795 DOI: https://doi.org/10.1186/s12913-019-4412-7
Capri S, Barbieri M, de Waure C, Boccalini S, Panatto D. Cost-effectiveness analysis of different seasonal influenza vaccines in the elderly Italian population. Hum Vaccin Immunother. 2018;14(6):1331-1341. https://doi.org/10.1080/21645515.2018.1438792 PMID:29425079 DOI: https://doi.org/10.1080/21645515.2018.1438792
Rosano A, Bella A, Gesualdo F, et al. Investigating the impact of influenza on excess mortality in all ages in Italy during recent seasons (2013/14-2016/17 seasons). Int J Infect Dis. 2019;88:127-134. https://doi.org/10.1016/j.ijid.2019.08.003 PMID:31401203 DOI: https://doi.org/10.1016/j.ijid.2019.08.003
Colamesta V, Tamburrano A, Barbara A, et al. Cost-consequence analysis of influenza vaccination among the staff of a large teaching hospital in Rome, Italy: A pilot study. PLoS One. 2019;14(11):e0225326. https://doi.org/10.1371/journal.pone.0225326 PMID:31725788 DOI: https://doi.org/10.1371/journal.pone.0225326
Pitrelli A. Introduction of a quadrivalent influenza vaccine in Italy: a budget impact analysis. J Prev Med Hyg. 2016;57(1):E34-E40. PMID:27346938
Dal Negro RW, Turco P, Povero M. Cost of influenza and influenza-like syndromes (I-LSs) in Italy: results of a cross-sectional telephone survey on a representative sample of general population. Respir Med. 2018;141:144-149. https://doi.org/10.1016/j.rmed.2018.07.001PMID:30053960 DOI: https://doi.org/10.1016/j.rmed.2018.07.001
Safety and immunogenicity of High-Dose Quadrivalent Influenza vaccine in Participants ≥65 years in the US. ClinicalTrials.gov -. Identifier NCT03282240, Online https://www.clinicaltrials.gov/ct2/show/results/NCT03282240?view=results; (ultimo accesso marzo 2021)
Chit A, Roiz J, Aballea S. An Assessment of the Expected Cost-Effectiveness of Quadrivalent Influenza Vaccines in Ontario, Canada Using a Static Model. PLoS One. 2015;10(7):e0133606. https://doi.org/10.1371/journal.pone.0133606 PMID:26222538 DOI: https://doi.org/10.1371/journal.pone.0133606
Scalone L, Cortesi PA, Ciampichini R, Cesana G, Mantovani LG. Health related quality of life norm data of the general population in Italy: results using the EQ-5D-3L and EQ-5D-5L instruments. EBPH 2015;12(3):e11457-1- e11457-15; disponibile su: https://www.researchgate.net/publication/283130623_Health_related_quality_of_life_norm_data_of_the_general_population_in_Italy_Results_using_the_EQ-5D-3L_and_EQ-5D-5L_instruments; (ultimo accesso giugno 2021)
Turner D, Wailoo A, Nicholson K, Cooper N, Sutton A, Abrams K. Systematic review and economic decision modelling for the prevention and treatment of influenza A and B. Health Technol Assess. 2003;7(35):1-170. https://doi.org/10.3310/hta7350. PMID: 14609480. DOI: https://doi.org/10.3310/hta7350
Istituto Superiore di Sanità (ISS) – Epicentro – Online https://www.epicentro.iss.it/; L’epidemiologia per la sanità pubblica – Influenza; (ultimo accesso marzo 2021)
Chit A, Becker DL, DiazGranados CA, Maschio M, Yau E, Drummond M. Cost-effectiveness of high-dose versus standard-dose inactivated influenza vaccine in adults aged 65 years and older: an economic evaluation of data from a randomised controlled trial. Lancet Infect Dis. 2015;15(12):1459-1466. https://doi.org/10.1016/S1473-3099(15)00249-2 PMID:26362172 DOI: https://doi.org/10.1016/S1473-3099(15)00249-2
van Aalst R, Russo EM, Neupane N, et al. Economic assessment of a high-dose versus a standard-dose influenza vaccine in the US Veteran population: estimating the impact on hospitalization cost for cardio-respiratory disease. Vaccine. 2019;37(32):4499-4503. https://doi.org/10.1016/j.vaccine.2019.06.066 PMID:31262590 DOI: https://doi.org/10.1016/j.vaccine.2019.06.066
23. WHO Guide on standardization of economic evaluations of immunization programmes. 2019. Online: https://apps.who.int/iris/bitstream/handle/10665/329389/WHO-IVB-19.10-eng.pdf?ua=1; (ultimo accesso aprile 2021)
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2021-07-06
Published 2021-08-04