Age- and risk-related appropriateness of the use of available influenza vaccines in the Italian elderly population is advantageous: results from a budget impact analysis.
Age- and risk-related appropriateness of the use of available influenza vaccines in the Italian elderly population is advantageous: results from a budget impact analysis.
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DOI：
10.15167/2421-4248/jpmh2017.58.4.867
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发表时间：
2017-12-01
影响因子：
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通讯作者：
Panatto, D
中科院分区：
文献类型：
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作者：
Barbieri, M;Capri, S;Panatto, D
简介：目前，意大利有四种不同类型的流感疫苗：三价(TIV)、四价(QIV)、MF59佐剂(ATIV)和皮内TIV(IdTIV)灭活疫苗。最近，意大利确立了使用不同疫苗的适当性(即根据年龄和风险因素)的概念。我们对意大利老年人(承担主要疾病负担)根据年龄和风险状况接种疫苗的政策转换进行了预算影响分析。方法：构建了一个新的预算影响模型，时间跨度为一个流感季节。在参考情景中，意大利老年人队列可以根据2017/18赛季的市场份额接种可用的疫苗。另一种方案设想给65-74岁和发生流感相关并发症的低风险人群注射TIV/QIV，而将ATIV/IDTIV分配给65-74岁的高危人群和所有75岁的≥受试者。结果：切换到另一种方案将带来显著的健康益处和净预算节省。特别是，将有可能预防另外8201例经实验室确认的流感病例、988例并发症、355例住院治疗和14例死亡。尽管替代策略与略高的疫苗接种成本相关，但较少的流感事件带来的总节省完全重置了这一增长，预算净节省为13万欧元。结论：根据意大利老年人的年龄和风险状况接种流感疫苗的免疫政策是可取的。
INTRODUCTION: Nowadays, four different types of influenza vaccines are available in Italy: trivalent (TIV), quadrivalent (QIV), MF59-adjuvanted (aTIV) and intradermal TIV (idTIV) inactivated vaccines. Recently, a concept of the appropriateness (i.e. according to the age and risk factors) of the use of different vaccines has been established in Italy. We conducted a budget impact analysis of switching to a policy, in which the Italian elderly (who carry the major disease burden) received the available vaccines according to their age and risk profile.METHODS: A novel budget impact model was constructed with a time horizon of one influenza season. In the reference scenario the cohort of Italian elderly individuals could receive either available vaccine according to 2017/18 season market share. The alternative scenario envisaged the administration of TIV/QIV to people aged 65-74 years and at low risk of developing influenza-related complications, while aTIV/idTIV were allocated to high-risk 65-74-year-olds and all subjects aged ≥ 75 years.RESULTS: Switching to the alternative scenario would result in both significant health benefits and net budget savings. Particularly, it would be possible to prevent an additional 8201 cases of laboratory-confirmed influenza, 988 complications, 355 hospitalizations and 14 deaths. Despite the alternative strategy being associated with slightly higher vaccination costs, the total savings derived from fewer influenza events completely resets this increase with net budget savings of 0.13 million.CONCLUSIONS: An immunization policy in which influenza vaccines are administered according to the age and risk profile of Italian elderly individuals is advisable.