Cost-Utility of Quadrivalent Versus Trivalent Influenza Vaccine in Germany, Using an Individual-Based Dynamic Transmission Model

Dolk, C., Eichner, M., Welte, R., Anastassopoulou, A., Van Bellinghen, L-A., Nautrup, B. P., Van Vlaenderen, I., Schmidt-Ott, R., Schwehm, M. & Postma, M., Dec-2016, In : Pharmacoeconomics. 34, 12, p. 1299-1308 10 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Christiaan Dolk
  • Martin Eichner
  • Robert Welte
  • Anastassia Anastassopoulou
  • Laure-Anne Van Bellinghen
  • Barbara Poulsen Nautrup
  • Ilse Van Vlaenderen
  • Ruprecht Schmidt-Ott
  • Markus Schwehm
  • Maarten Postma

Seasonal influenza infection is primarily caused by circulation of two influenza A strain subtypes and strains from two B lineages that vary each year. Trivalent influenza vaccine (TIV) contains only one of the two B-lineage strains, resulting in mismatches between vaccine strains and the predominant circulating B lineage. Quadrivalent influenza vaccine (QIV) includes both B-lineage strains. The objective was to estimate the cost-utility of introducing QIV to replace TIV in Germany.

An individual-based dynamic transmission model (4Flu) using German data was used to provide realistic estimates of the impact of TIV and QIV on age-specific influenza infections. Cases were linked to health and economic outcomes to calculate the cost-utility of QIV versus TIV, from both a societal and payer perspective. Costs and effects were discounted at 3.0 and 1.5 % respectively, with 2014 as the base year. Univariate and probabilistic sensitivity analyses were conducted.

Using QIV instead of TIV resulted in additional quality-adjusted life-years (QALYs) and cost savings from the societal perspective (i.e. it represents the dominant strategy) and an incremental cost-utility ratio (ICUR) of a,not sign14,461 per QALY from a healthcare payer perspective. In all univariate analyses, QIV remained cost-effective (ICUR <a,not sign50,000). In probabilistic sensitivity analyses, QIV was cost-effective in > 98 and > 99 % of the simulations from the societal and payer perspective, respectively.

This analysis suggests that QIV in Germany would provide additional health gains while being cost-saving to society or costing a,not sign14,461 per QALY gained from the healthcare payer perspective, compared with TIV.

Original languageEnglish
Pages (from-to)1299-1308
Number of pages10
Issue number12
Publication statusPublished - Dec-2016



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