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Cost-effectiveness analysis of cell-based versus egg-based quadrivalent influenza vaccines in the pediatric
Chia-Yu Chi1, Ming-Fang Cheng2, Karam Ko3
1National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli, Taiwan.
Insights
Switching to cell-based quadrivalent influenza vaccine (QIVc) in children is cost-effective compared to egg-derived vaccines (QIVe). QIVc reduces influenza cases and hospitalizations, offering greater benefits during seasons with high egg adaptation.
Area of Science:
- Vaccinology
- Health Economics
- Epidemiology
Background:
- Cell-based influenza vaccines (QIVc) bypass egg-adaptive mutations, potentially enhancing vaccine effectiveness over egg-derived quadrivalent influenza vaccines (QIVe).
- Influenza poses a significant disease burden, particularly in pediatric populations, necessitating evaluation of vaccine strategies.
Purpose of the Study:
- To assess the one-season cost-effectiveness of QIVc compared to QIVe in children aged 6 months to 17 years in Taiwan.
- To analyze costs and outcomes from both payer and societal perspectives.
Main Methods:
- An age-stratified static model was employed to compare QIVc and QIVe.
- Base case and high egg adaptation scenarios were evaluated.
- Deterministic and probabilistic sensitivity analyses were conducted, with an ICER threshold of USD 99,177/QALY.
Main Results:
- QIVc is projected to prevent 15,665 influenza cases, 2,244 complicated cases, and 259 hospitalizations annually per year compared to QIVe.
- Base case incremental cost-effectiveness ratios (ICERs) were USD 68,298/QALY (payer) and USD 40,085/QALY (societal).
- In a high egg adaptation scenario, ICERs decreased to USD 45,782/QALY (payer) and USD 17,489/QALY (societal).
Conclusions:
- Transitioning the pediatric immunization strategy from QIVe to QIVc is predicted to be cost-effective in Taiwan.
- QIVc adoption is expected to reduce the overall influenza-associated disease burden.
- The cost-effectiveness and benefits of QIVc are amplified during influenza seasons with significant egg adaptation.
Abstract:
Cell-based influenza vaccines avoid egg-adaptive mutations, potentially improving vaccine effectiveness. We assessed the one-season cost-effectiveness of cell-based quadrivalent influenza vaccine (QIVc) against that of egg-derived quadrivalent influenza vaccines (QIVe) in children (6 months to 17 years of age) from payer and societal perspectives in Taiwan using an age-stratified static model. Base case and high egg adaptation scenarios were assessed. Deterministic and probabilistic sensitivity analyses were performed. The incremental cost-effectiveness ratio (ICER) threshold in Taiwan was assumed to be USD 99 177/quality-adjusted life year (QALY). Compared to QIVe, QIVc would prevent 15 665 influenza cases, 2244 complicated cases, and 259 hospitalizations per year. The base case ICER was USD 68 298/QALY and USD 40 085/QALY from the payer and societal perspective, respectively. In the high egg adaptation scenario, the ICER was USD 45 782/QALY from the payer's perspective and USD 17 489/QALY from the societal perspective. Deterministic sensitivity analyses indicated that infection incidence rate, vaccination coverage, and prevalence of the A/H3N2 strain were the main drivers of ICER. In conclusion, switching the immunization strategy from QIVe to QIVc is predicted to reduce the influenza-associated disease burden and be cost-effective for the pediatric population in Taiwan. The potential benefits of QIVc would be even higher during influenza seasons with high levels of egg adaptation.
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