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Appl Health Econ Health Policy. 2017 Apr;15(2):261-276. doi: 10.1007/s40258-016-0296-4.

Assessment of Public Health and Economic Impact of Intranasal Live-Attenuated Influenza Vaccination of Children in France Using a Dynamic Transmission Model.

Author information

1
QuintilesIMS Real-World Evidence Solutions, Corporate Village, Davos Building, Da Vincilaan 7, 1935, Zaventem, Belgium. Laetitia.Gerlier@quintilesims.com.
2
QuintilesIMS Real-World Evidence Solutions, Corporate Village, Davos Building, Da Vincilaan 7, 1935, Zaventem, Belgium.
3
AstraZeneca, Rueil-Malmaison, France.
4
Department of Medical Information, University Lille Nord de France, Lille, France.
5
Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France.
6
Public Health Department, Saint-Antoine Hospital, APHP, Paris, France.
7
Department of Pediatrics, University Paris VII, Paris, France.
8
Department of Health Economics and Health Care Management, Bielefeld School of Public Health, Bielefeld University, Bielefeld, Germany.
9
ExploSYS GmbH, Leinfelden-Echterdingen, Germany.
10
Institute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany.
11
Epimos GmbH, Dusslingen, Germany.

Abstract

OBJECTIVES:

We estimated the epidemiological and economic impact of extending the French influenza vaccination programme from at-risk/elderly (≥65 years) only to healthy children (2-17 years).

METHODS:

A deterministic, age-structured, dynamic transmission model was used to simulate the transmission of influenza in the French population, using the current vaccination coverage with trivalent inactivated vaccine (TIV) in at-risk/elderly individuals (current strategy) or gradually extending the vaccination to healthy children (aged 2-17 years) with intranasal, quadrivalent live-attenuated influenza vaccine (QLAIV) from current uptake up to 50% (evaluated strategy). Epidemiological, medical resource use and cost data were taken from international literature and country-specific information. The model was calibrated to the observed numbers of influenza-like illness visits/year. The 10-year number of symptomatic cases of confirmed influenza and direct medical costs ('all-payer') were calculated for the 0-17- (direct and indirect effects) and ≥18-year-old (indirect effect). The incremental cost-effectiveness ratio (ICER) was calculated for the total population, using a 4% discount rate/year.

RESULTS:

Assuming 2.3 million visits/year and 1960 deaths/year, the model calibration yielded an all-year average basic reproduction number (R 0) of 1.27. In the population aged 0-17 years, QLAIV prevented 865,000 influenza cases/year (58.4%), preventing 10-year direct medical expenses of €374 million. In those aged ≥18 years with unchanged TIV coverage, 1.2 million cases/year were averted (27.6%) via indirect effects (additionally prevented expenses, €457 million). On average, 613 influenza-related deaths were averted annually overall. The ICER was €18,001/life-year gained. The evaluated strategy had a 98% probability of being cost-effective at a €31,000/life-year gained threshold.

CONCLUSIONS:

The model demonstrated strong direct and indirect benefits of protecting healthy children against influenza with QLAIV on public health and economic outcomes in France.

PMID:
27943165
DOI:
10.1007/s40258-016-0296-4
[Indexed for MEDLINE]

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