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J Am Geriatr Soc. 2016 Oct;64(10):2126-2131. doi: 10.1111/jgs.14323. Epub 2016 Oct 6.

Cost-Effectiveness and Public Health Effect of Influenza Vaccine Strategies for U.S. Elderly Adults.

Author information

1
School of Medicine, University of Pittsburgh, Pennsylvania. raviottaj@upmc.edu.
2
School of Medicine, University of Pittsburgh, Pennsylvania.
3
Pittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, Pennsylvania.
4
Department of Mathematics, Soongsil University, Seoul, South Korea.

Abstract

OBJECTIVES:

To compare the cost-effectiveness of four influenza vaccines available in the United States for persons aged 65 and older: trivalent inactivated influenza vaccine (IIV3), quadrivalent inactivated influenza vaccine (IIV4), a more-expensive high-dose IIV3, and a newly approved adjuvanted IIV3.

DESIGN:

Cost-effectiveness analysis using a Markov model and sensitivity analyses.

SETTING:

A hypothetical influenza vaccination season modeled according to possible U.S. influenza vaccination policies.

PARTICIPANTS:

Hypothetical cohort of individuals aged 65 and older in the United States.

MEASUREMENTS:

Cost-effectiveness and public health benefits of available influenza vaccination strategies in U.S. elderly adults.

RESULTS:

IIV3 cost $3,690 per quality-adjusted life year (QALY) gained, IIV4 cost $20,939 more than IIV3 per QALY gained, and high-dose IIV3 cost $31,214 more per QALY than IIV4. The model projected 83,775 fewer influenza cases and 980 fewer deaths with high-dose IIV3 than with the next most-effective vaccine: IIV4. In a probabilistic sensitivity analysis, high-dose IIV3 was the favored strategy if willingness to pay is $25,000 or more per QALY gained. Adjuvanted IIV3 cost-effectiveness depends on its price and effectiveness (neither yet determined in the United States) but could be favored if its relative effectiveness is 15% greater than that of IIV3.

CONCLUSION:

From economic and public health standpoints, high-dose IIV3 for adults aged 65 years and older is likely to be favored over the other vaccines, based on currently available data. The cost-effectiveness of adjuvanted IIV3 should be reviewed after its effectiveness has been compared with that of other vaccines and its U.S. price is established.

KEYWORDS:

cost effectiveness; high-dose IIV3; influenza vaccination

PMID:
27709600
PMCID:
PMC5302117
DOI:
10.1111/jgs.14323
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Checklist: Elements of Financial/Personal Conflicts J Raviotta K Smith J DePasse S Brown Yes No Yes No Yes No Yes No Employment or Affiliation X X X X Grants/Funds X X X X Honoraria X X X X Speaker Forum X X X X Consultant X X X X Stocks X X X X Royalties X X X X Expert Testimony X X X X Board Member X X X X Patents X X X X Personal Relationship X X X X Elements of Financial/Personal Conflicts E Shim MP Nowalk R Zimmerman Yes No Yes No Yes No Employment or Affiliation X X X Grants/Funds X X X Honoraria X X X Speaker Forum X X X Consultant X X X Stocks X X X Royalties X X X Expert Testimony X X X Board Member X X X Patents X X X Personal Relationship X X X *Authors can be listed by abbreviations of their names. For “yes” x mark(s): give brief explanation below: Dr. Zimmerman has active research grants from Sanofi Pasteur, Merck & Co., Inc., and Pfizer Inc. Mary Patricia Nowalk has received or currently receives grant funding from Pfizer, Inc., and Merck & Co., Inc. and in the past was a consultant to MedImmune, LLC. Jonathan Raviotta currently receives grant funding from Pfizer, Inc. and Merck & Co., Inc. All other authors have no conflicts of interest to disclose.

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