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The cost-effectiveness of trivalent and quadrivalent influenza vaccination in communities in South Africa, Vietnam and Australia

de Boer, P. T., Kelso, J. K., Halder, N., Nguyen, T-P-L., Moyes, J., Cohen, C., Barr, I. G., Postma, M. J. & Milne, G. J., 8-Feb-2018, In : Vaccine. 36, 7, p. 997-1007 11 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Pieter T de Boer
  • Joel K Kelso
  • Nilimesh Halder
  • Thi-Phuong-Lan Nguyen
  • Jocelyn Moyes
  • Cheryl Cohen
  • Ian G Barr
  • Maarten J Postma
  • George J Milne

BACKGROUND: To inform national healthcare authorities whether quadrivalent influenza vaccines (QIVs) provide better value for money than trivalent influenza vaccines (TIVs), we assessed the cost-effectiveness of TIV and QIV in low-and-middle income communities based in South Africa and Vietnam and contrasted these findings with those from a high-income community in Australia.

METHODS: Individual based dynamic simulation models were interfaced with a health economic analysis model to estimate the cost-effectiveness of vaccinating 15% of the population with QIV or TIV in each community over the period 2003-2013. Vaccination was prioritized for HIV-infected individuals, before elderly aged 65+ years and young children. Country or region-specific data on influenza-strain circulation, clinical outcomes and costs were obtained from published sources. The societal perspective was used and outcomes were expressed in International$ (I$) per quality-adjusted life-year (QALY) gained.

RESULTS: When compared with TIV, we found that QIV would provide a greater reduction in influenza-related morbidity in communities in South Africa and Vietnam as compared with Australia. The incremental cost-effectiveness ratio of QIV versus TIV was estimated at I$4183/QALY in South Africa, I$1505/QALY in Vietnam and I$80,966/QALY in Australia.

CONCLUSIONS: The cost-effectiveness of QIV varied between communities due to differences in influenza epidemiology, comorbidities, and unit costs. Whether TIV or QIV is the most cost-effective alternative heavily depends on influenza B burden among subpopulations targeted forvaccination in addition to country-specific willingness-to-pay thresholds and budgetary impact.

Original languageEnglish
Pages (from-to)997-1007
Number of pages11
JournalVaccine
Volume36
Issue number7
Early online date17-Jan-2018
Publication statusPublished - 8-Feb-2018

    Keywords

  • Influenza, Cost-effectiveness, Vaccination, Trivalent, Quadrivalent, Dynamic transmission model, MIDDLE-INCOME COUNTRIES, PANDEMIC INFLUENZA, UNITED-STATES, VACCINES, SURVEILLANCE, EFFICACY, COHORT, EPIDEMIOLOGY, IMMUNIZATION, CHILDREN

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