Cost-effectiveness of routine annual influenza vaccination by age and risk status.
Cost-effectiveness of routine annual influenza vaccination by age and risk status.
复制标题
按年龄和风险状况划分的每年常规流感疫苗接种的成本效益。
DOI：
10.1016/j.vaccine.2023.04.069
复制
发表时间：
2023
期刊：
影响因子：
5.5
通讯作者：
Prosser,LisaA
中科院分区：
文献类型：
--
作者：
KimDeLuca,Ellen;Gebremariam,Acham;Rose,Angela;Biggerstaff,Matthew;Meltzer,MartinI;Prosser,LisaA
Background The epidemiology of circulating seasonal influenza strains changed following the 2009 pandemic influenza A (H1N1). A universal influenza vaccination recommendation has been implemented and new vaccine types have become available post-2009. The objective of this study was to evaluate the cost-effectiveness of routine annual influenza vaccination in the context of this new evidence. Methods A state transition simulation model was constructed to estimate the health and economic outcomes of influenza vaccination compared to no vaccination for hypothetical US cohorts stratified by age and risk status. Model input parameters were derived from multiple sources, including post-2009 vaccine effectiveness data from the US Flu Vaccine Effectiveness Network. The analysis used societal and healthcare sector perspectives and a one-year time horizon, except permanent outcomes were also included. The primary outcome was the incremental cost-effectiveness ratio (ICER) in dollars per quality-adjusted life years (QALYs) gained. Results Compared to no vaccination, vaccination yielded ICERs lower than $95,000/QALY for all age and risk groups, except for non-high-risk adults 18–49 years ($194,000/QALY). Vaccination was cost-saving for adults≥ 50 years at higher risk for influenza-related complications. Results were most sensitive to changes in the probability of influenza illness. Performing the analysis from the healthcare sector perspective, excluding vaccination time costs, delivering vaccinations in lower-cost settings, and including productivity losses improved the cost-effectiveness of vaccination. Sensitivity analysis revealed that vaccination remains below $100,000/QALY for older persons≥ 65 years at vaccine effectiveness estimates as low as 4%. Conclusions Cost-effectiveness of influenza vaccination varied by age and risk status and was less than $95,000/QALY for all subgroups, except for non-high-risk working-age adults. Results were sensitive to the probability of influenza illness and vaccination was more favorable under certain scenarios. Vaccination for higher risk subgroups resulted in ICERs below $100,000/QALY even at low levels of vaccine effectiveness or circulating virus.
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DOI：
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