Barbieri M, Capri S, Waure C DE, Boccalini S, Panatto D
Centre for Health Economics, University of York, York, UK.
School of Economics and Management, Cattaneo University-LIUC, Castellanza, Italy.
J Prev Med Hyg. 2017 Dec 30;58(4):E279-E287. doi: 10.15167/2421-4248/jpmh2017.58.4.867. eCollection 2017 Dec.
Nowadays, four different types of influenza vaccines are available in Italy: trivalent (TIV), quadrivalent (QIV), MF59-adjuvanted (aTIV) and intradermal TIV (idTIV) inactivated vaccines. Recently, a concept of the appropriateness (i.e. according to the age and risk factors) of the use of different vaccines has been established in Italy. We conducted a budget impact analysis of switching to a policy, in which the Italian elderly (who carry the major disease burden) received the available vaccines according to their age and risk profile.
A novel budget impact model was constructed with a time horizon of one influenza season. In the reference scenario the cohort of Italian elderly individuals could receive either available vaccine according to 2017/18 season market share. The alternative scenario envisaged the administration of TIV/QIV to people aged 65-74 years and at low risk of developing influenza-related complications, while aTIV/idTIV were allocated to high-risk 65-74-year-olds and all subjects aged ≥ 75 years.
Switching to the alternative scenario would result in both significant health benefits and net budget savings. Particularly, it would be possible to prevent an additional 8201 cases of laboratory-confirmed influenza, 988 complications, 355 hospitalizations and 14 deaths. Despite the alternative strategy being associated with slightly higher vaccination costs, the total savings derived from fewer influenza events completely resets this increase with net budget savings of € 0.13 million.
An immunization policy in which influenza vaccines are administered according to the age and risk profile of Italian elderly individuals is advisable.
如今,意大利有四种不同类型的流感疫苗可供使用:三价(TIV)、四价(QIV)、MF59佐剂(aTIV)和皮内TIV(idTIV)灭活疫苗。最近,意大利已确立了根据不同疫苗使用的适宜性(即根据年龄和风险因素)这一概念。我们对转向一项政策进行了预算影响分析,在该政策中,意大利老年人(承担主要疾病负担者)根据其年龄和风险状况接种可用疫苗。
构建了一个新颖的预算影响模型,时间跨度为一个流感季节。在参考情景中,意大利老年人群体可根据2017/18季节市场份额接种任意一种可用疫苗。替代情景设想为65 - 74岁且患流感相关并发症风险较低的人群接种TIV/QIV,而将aTIV/idTIV分配给65 - 74岁的高风险人群以及所有75岁及以上的人群。
转向替代情景将带来显著的健康益处和预算净节省。特别是,有可能额外预防8201例实验室确诊的流感病例、988例并发症、355例住院治疗和14例死亡。尽管替代策略的疫苗接种成本略高,但流感事件减少带来的总节省完全抵消了这一增加,预算净节省为13万欧元。
建议实施一项根据意大利老年人的年龄和风险状况接种流感疫苗的免疫政策。