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

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.

journal_name

J Am Geriatr Soc

authors

Raviotta JM,Smith KJ,DePasse J,Brown ST,Shim E,Nowalk MP,Zimmerman RK

doi

10.1111/jgs.14323

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

2126-2131

issue

10

eissn

0002-8614

issn

1532-5415

journal_volume

64

pub_type

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