Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England

Abstract Background As part of the national seasonal influenza vaccination programme in England and Wales, children receive a quadrivalent vaccine offering protection against two influenza A strains and two influenza B strains. Healthy children receive a quadrivalent live attenuated influenza vaccin...

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Main Authors: Dominic Thorrington, Edwin van Leeuwen, Mary Ramsay, Richard Pebody, Marc Baguelin
Format: Article
Language:English
Published: BMC 2017-09-01
Series:BMC Medicine
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12916-017-0932-3
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spelling doaj-324942faea9b4fe6b6c7d834cf3b272e2020-11-25T00:35:18ZengBMCBMC Medicine1741-70152017-09-011511910.1186/s12916-017-0932-3Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in EnglandDominic Thorrington0Edwin van Leeuwen1Mary Ramsay2Richard Pebody3Marc Baguelin4Respiratory Diseases Department, Public Health EnglandRespiratory Diseases Department, Public Health EnglandImmunisation, Hepatitis & Blood Safety Department, Public Health EnglandRespiratory Diseases Department, Public Health EnglandRespiratory Diseases Department, Public Health EnglandAbstract Background As part of the national seasonal influenza vaccination programme in England and Wales, children receive a quadrivalent vaccine offering protection against two influenza A strains and two influenza B strains. Healthy children receive a quadrivalent live attenuated influenza vaccine (QLAIV), whilst children with contraindications receive the quadrivalent inactivated influenza vaccine (QIIV). Individuals aged younger than 65 years in the clinical risk populations and elderly individuals aged 65+ years receive either a trivalent inactivated influenza vaccine (TIIV) offering protection from two A strains and one B strain or the QIIV at the choice of their general practitioner. The cost-effectiveness of quadrivalent vaccine programmes is an open question. The original analysis that supported the paediatric programme only considered a trivalent live attenuated vaccine (LAIV). The cost-effectiveness of the QIIV to other patients has not been established. We sought to estimate the cost-effectiveness of these programmes, establishing a maximum incremental total cost per dose of quadrivalent vaccines over trivalent vaccines. Methods We used the same mathematical model as the analysis that recommended the introduction of the paediatric influenza vaccination programme. The incremental cost of the quadrivalent vaccine is the additional cost over that of the existing trivalent vaccine currently in use. Results Introducing quadrivalent vaccines can be cost-effective for all targeted groups. However, the cost-effectiveness of the programme is dependent on the choice of target cohort and the cost of the vaccines: the paediatric programme is cost-effective with an increased cost of £6.36 per dose, though an extension to clinical risk individuals younger than 65 years old and further to all elderly individuals means the maximum incremental cost is £1.84 and £0.20 per dose respectively. Conclusions Quadrivalent influenza vaccines will bring substantial health benefits, as they are cost-effective in particular target groups.http://link.springer.com/article/10.1186/s12916-017-0932-3InfluenzaVaccinationQuadrivalent vaccinesCost-effectivenessQALYLAIV
collection DOAJ
language English
format Article
sources DOAJ
author Dominic Thorrington
Edwin van Leeuwen
Mary Ramsay
Richard Pebody
Marc Baguelin
spellingShingle Dominic Thorrington
Edwin van Leeuwen
Mary Ramsay
Richard Pebody
Marc Baguelin
Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England
BMC Medicine
Influenza
Vaccination
Quadrivalent vaccines
Cost-effectiveness
QALY
LAIV
author_facet Dominic Thorrington
Edwin van Leeuwen
Mary Ramsay
Richard Pebody
Marc Baguelin
author_sort Dominic Thorrington
title Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England
title_short Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England
title_full Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England
title_fullStr Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England
title_full_unstemmed Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England
title_sort cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in england
publisher BMC
series BMC Medicine
issn 1741-7015
publishDate 2017-09-01
description Abstract Background As part of the national seasonal influenza vaccination programme in England and Wales, children receive a quadrivalent vaccine offering protection against two influenza A strains and two influenza B strains. Healthy children receive a quadrivalent live attenuated influenza vaccine (QLAIV), whilst children with contraindications receive the quadrivalent inactivated influenza vaccine (QIIV). Individuals aged younger than 65 years in the clinical risk populations and elderly individuals aged 65+ years receive either a trivalent inactivated influenza vaccine (TIIV) offering protection from two A strains and one B strain or the QIIV at the choice of their general practitioner. The cost-effectiveness of quadrivalent vaccine programmes is an open question. The original analysis that supported the paediatric programme only considered a trivalent live attenuated vaccine (LAIV). The cost-effectiveness of the QIIV to other patients has not been established. We sought to estimate the cost-effectiveness of these programmes, establishing a maximum incremental total cost per dose of quadrivalent vaccines over trivalent vaccines. Methods We used the same mathematical model as the analysis that recommended the introduction of the paediatric influenza vaccination programme. The incremental cost of the quadrivalent vaccine is the additional cost over that of the existing trivalent vaccine currently in use. Results Introducing quadrivalent vaccines can be cost-effective for all targeted groups. However, the cost-effectiveness of the programme is dependent on the choice of target cohort and the cost of the vaccines: the paediatric programme is cost-effective with an increased cost of £6.36 per dose, though an extension to clinical risk individuals younger than 65 years old and further to all elderly individuals means the maximum incremental cost is £1.84 and £0.20 per dose respectively. Conclusions Quadrivalent influenza vaccines will bring substantial health benefits, as they are cost-effective in particular target groups.
topic Influenza
Vaccination
Quadrivalent vaccines
Cost-effectiveness
QALY
LAIV
url http://link.springer.com/article/10.1186/s12916-017-0932-3
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