From trivalent to quadrivalent influenza vaccines: Public health and economic burden for different immunization strategies in Spain
From trivalent to quadrivalent influenza vaccines: Public health and economic burden for different immunization strategies in Spain
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DOI：
10.1371/journal.pone.0233526
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发表时间：
2020-05-21
期刊：
影响因子：
3.7
通讯作者：
Solozabal, Miriam
中科院分区：
文献类型：
--
作者：
Crepey, Pascal;Redondo, Esther;Solozabal, Miriam
目的四价流感疫苗（Quadrivalent influenza vaccine，QIV）包括与三价流感疫苗（triple influenza vaccine，TIV）相同的毒株，外加另一个B谱系的B毒株。该研究的目的是分析公共卫生和经济的影响，以取代TIV与QIV在不同的情况下在Spains.MethodsA动态传输模型的开发，以估计根据TIV和QIV策略（< 65岁（高风险）和>= 65岁）预防的流感B病例数。该模型考虑了由不同谱系的流感B诱导的交叉保护性免疫。传输模型的输出被用作决策树模型的输入，该模型估计将TIV转换为QIV的经济影响。这些模型尽可能使用西班牙数据。确定性的单变量和概率多变量的敏感性analyses. ResultsReplacement TIV与QIV在所有符合条件的患者与目前的疫苗覆盖率在西班牙可能已经防止了138,707例流感B每个季节，因此避免了10,748门诊就诊，3,179住院治疗和192例死亡。更换可以节省（原文如此）532，768门诊费用，（原文如此）1300万住院费用，（原文如此）每年流感相关死亡费用300万。从社会的角度来看，每年可以节省与生产力损失有关的额外费用500万美元。从社会角度来看，预算影响将为650万，每质量调整生命年的增量成本效益比为1,527。敏感性分析显示了稳健的结果。在其他情况下，QIV还显示了在公共卫生水平的影响，减少流感B相关的病例，门诊，住院和deaths.ConclusionsOur结果显示公共卫生和经济效益与QIV流感预防。这将是一个有效的干预西班牙国家卫生服务与重大的健康效益，特别是在人口。
PurposeQuadrivalent influenza vaccine (QIV) includes the same strains as trivalent influenza vaccine (TIV) plus an additional B strain of the other B lineage. The aim of the study was to analyse the public health and economic impact of replacing TIV with QIV in different scenarios in Spain.MethodsA dynamic transmission model was developed to estimate the number of influenza B cases prevented under TIV and QIV strategies (< 65 years (high risk) and >= 65 years). This model considers cross-protective immunity induced by different lineages of influenza B. The output of the transmission model was used as input for a decision tree model that estimated the economic impact of switching TIV to QIV. The models were populated with Spanish data whenever possible. Deterministic univariate and probabilistic multivariate sensitivity analyses were performed.ResultsReplacing TIV with QIV in all eligible patients with current vaccine coverage in Spain may have prevented 138,707 influenza B cases per season and, therefore avoided 10,748 outpatient visits, 3,179 hospitalizations and 192 deaths. The replacement could save (sic) 532,768 in outpatient visit costs, (sic) 13 million in hospitalization costs, and (sic) 3 million in costs of influenza-related deaths per year. An additional (sic) 5 million costs associated with productivity loss could be saved per year, from the societal perspective. The budget impact from societal perspective would be (sic) 6.5 million, and the incremental cost-effectiveness ratio (ICER) (sic) 1,527 per quality-adjusted life year (QALY). Sensitivity analyses showed robust results. In additional scenarios, QIV also showed an impact at public health level reducing influenza B related cases, outpatient visits, hospitalizations and deaths.ConclusionsOur results show public health and economic benefits for influenza prevention with QIV. It would be an efficient intervention for the Spanish National Health Service with major health benefits especially in the population.65-year.