Limits...
The potential cost-effectiveness of quadrivalent versus trivalent influenza vaccine in elderly people and clinical risk groups in the UK: a lifetime multi-cohort model.

Van Bellinghen LA, Meier G, Van Vlaenderen I - PLoS ONE (2014)

Bottom Line: To estimate the potential cost-effectiveness of quadrivalent influenza vaccine compared with trivalent influenza vaccine in the UK.Herd effect was not included.Quadrivalent influenza vaccine could reduce influenza disease burden and would be cost-effective compared with trivalent influenza vaccine in elderly people and clinical risk groups in the UK.

View Article: PubMed Central - PubMed

Affiliation: CHESS, Ternat, Belgium.

ABSTRACT

Objective: To estimate the potential cost-effectiveness of quadrivalent influenza vaccine compared with trivalent influenza vaccine in the UK.

Methods: A lifetime, multi-cohort, static Markov model was constructed, with nine age groups each divided into healthy and at-risk categories. Influenza A and B were accounted for separately. The model was run in one-year cycles for a lifetime (maximum age: 100 years). The analysis was from the perspective of the UK National Health Service. Costs and benefits were discounted at 3.5%. 2010 UK vaccination policy (vaccination of people at risk and those aged ≥65 years) was applied. Herd effect was not included. Inputs were derived from national databases and published sources where possible. The quadrivalent influenza vaccine price was not available when the study was conducted. It was estimated at £6.72,15% above the trivalent vaccine price of £5.85. Sensitivity analyses used an incremental price of up to 50%.

Results: Compared with trivalent influenza vaccine, the quadrivalent influenza vaccine would be expected to reduce the numbers of influenza cases by 1,393,720, medical visits by 439,852 complications by 167,357, hospitalisations for complications by 26,424 and influenza deaths by 16,471. The estimated base case incremental cost-effectiveness ratio (ICER) was £5,299/quality-adjusted life-year (QALY). Sensitivity analyses indicated that the ICER was sensitive to changes in circulation of influenza virus subtypes and vaccine mismatch; all other parameters had little effect. In 96% of simulations the ICER was <£20,000/QALY. Since this analysis was completed, quadrivalent influenza vaccine has become available in the UK at a list price of £9.94. Using this price in the model, the estimated ICER for quadrivalent compared with trivalent vaccination was £27,378/QALY, still within the NICE cost-effectiveness threshold (£20,000-£30,000).

Conclusions: Quadrivalent influenza vaccine could reduce influenza disease burden and would be cost-effective compared with trivalent influenza vaccine in elderly people and clinical risk groups in the UK.

Show MeSH

Related in: MedlinePlus

Influenza cases and deaths averted by quadrivalent vaccination over time.A: Cumulative number of influenza cases expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model. B: Cumulative number of influenza deaths expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4048201&req=5

pone-0098437-g003: Influenza cases and deaths averted by quadrivalent vaccination over time.A: Cumulative number of influenza cases expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model. B: Cumulative number of influenza deaths expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model.

Mentions: Figure 3A and Figure 3B show the number of influenza cases and deaths, respectively, predicted to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model. In the first year, individuals of all nine age groups enter the model according to the population age distribution. In the first year, quadrivalent vaccination would be expected to avert 17,088 additional influenza cases and 168 influenza deaths. As the cohorts age and move through the model, the number of cases and deaths averted each year is added to the total. By year 100, the accumulated number of cases averted would be 1,393,720 and the number of deaths averted would be 16,471. There are two inflection points in the curves, reflecting age-related changes in the percentages of healthy individuals who receive influenza vaccination; this percentage increases from 0% to 71.19% in the group aged 65+ years. The first occurs at 15 years when the individuals who entered the model at age 50 years (representing 44% of the population) reach the age of 65 years, and the second occurs at 47 years when the individuals who entered the model at age 18 years (representing 18% of the population) reach the age of 65 years.


The potential cost-effectiveness of quadrivalent versus trivalent influenza vaccine in elderly people and clinical risk groups in the UK: a lifetime multi-cohort model.

Van Bellinghen LA, Meier G, Van Vlaenderen I - PLoS ONE (2014)

Influenza cases and deaths averted by quadrivalent vaccination over time.A: Cumulative number of influenza cases expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model. B: Cumulative number of influenza deaths expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4048201&req=5

pone-0098437-g003: Influenza cases and deaths averted by quadrivalent vaccination over time.A: Cumulative number of influenza cases expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model. B: Cumulative number of influenza deaths expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model.
Mentions: Figure 3A and Figure 3B show the number of influenza cases and deaths, respectively, predicted to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model. In the first year, individuals of all nine age groups enter the model according to the population age distribution. In the first year, quadrivalent vaccination would be expected to avert 17,088 additional influenza cases and 168 influenza deaths. As the cohorts age and move through the model, the number of cases and deaths averted each year is added to the total. By year 100, the accumulated number of cases averted would be 1,393,720 and the number of deaths averted would be 16,471. There are two inflection points in the curves, reflecting age-related changes in the percentages of healthy individuals who receive influenza vaccination; this percentage increases from 0% to 71.19% in the group aged 65+ years. The first occurs at 15 years when the individuals who entered the model at age 50 years (representing 44% of the population) reach the age of 65 years, and the second occurs at 47 years when the individuals who entered the model at age 18 years (representing 18% of the population) reach the age of 65 years.

Bottom Line: To estimate the potential cost-effectiveness of quadrivalent influenza vaccine compared with trivalent influenza vaccine in the UK.Herd effect was not included.Quadrivalent influenza vaccine could reduce influenza disease burden and would be cost-effective compared with trivalent influenza vaccine in elderly people and clinical risk groups in the UK.

View Article: PubMed Central - PubMed

Affiliation: CHESS, Ternat, Belgium.

ABSTRACT

Objective: To estimate the potential cost-effectiveness of quadrivalent influenza vaccine compared with trivalent influenza vaccine in the UK.

Methods: A lifetime, multi-cohort, static Markov model was constructed, with nine age groups each divided into healthy and at-risk categories. Influenza A and B were accounted for separately. The model was run in one-year cycles for a lifetime (maximum age: 100 years). The analysis was from the perspective of the UK National Health Service. Costs and benefits were discounted at 3.5%. 2010 UK vaccination policy (vaccination of people at risk and those aged ≥65 years) was applied. Herd effect was not included. Inputs were derived from national databases and published sources where possible. The quadrivalent influenza vaccine price was not available when the study was conducted. It was estimated at £6.72,15% above the trivalent vaccine price of £5.85. Sensitivity analyses used an incremental price of up to 50%.

Results: Compared with trivalent influenza vaccine, the quadrivalent influenza vaccine would be expected to reduce the numbers of influenza cases by 1,393,720, medical visits by 439,852 complications by 167,357, hospitalisations for complications by 26,424 and influenza deaths by 16,471. The estimated base case incremental cost-effectiveness ratio (ICER) was £5,299/quality-adjusted life-year (QALY). Sensitivity analyses indicated that the ICER was sensitive to changes in circulation of influenza virus subtypes and vaccine mismatch; all other parameters had little effect. In 96% of simulations the ICER was <£20,000/QALY. Since this analysis was completed, quadrivalent influenza vaccine has become available in the UK at a list price of £9.94. Using this price in the model, the estimated ICER for quadrivalent compared with trivalent vaccination was £27,378/QALY, still within the NICE cost-effectiveness threshold (£20,000-£30,000).

Conclusions: Quadrivalent influenza vaccine could reduce influenza disease burden and would be cost-effective compared with trivalent influenza vaccine in elderly people and clinical risk groups in the UK.

Show MeSH
Related in: MedlinePlus