Ruiz-Aragón Jesús, Gani Ray, Márquez Sergio, Alvarez Piedad
FEA de Microbiología Clínica, Hospital Universitario de Puerto Real , Cádiz, Spain.
Modeling and Simulation, Evidera , London, UK.
Hum Vaccin Immunother. 2020 Sep 1;16(9):2238-2244. doi: 10.1080/21645515.2020.1712935. Epub 2020 Feb 10.
Influenza is a viral respiratory disease that causes significant clinical and economic burden globally. Quadrivalent influenza vaccine (QIV) is frequently used to protect people who have a high-risk of developing influenza complications due to comorbidities. QIV offers protection against influenza A (A/H1N1 and H3N2) and B (B/Victoria, and B/Yamagata) strains. The European Medicines Agency has recently approved a cell-based QIV (QIVc) in people aged over 9 years old. QIVc has been shown to be more effective at preventing influenza than traditional egg-based QIV (QIVe). In this study, we use a health economic model adapted to Spain to assess the costs and outcomes associated with using QIVc instead of QIVe in people aged 9-64 at high-risk of complications. Observed vaccine coverage of 32% in the 9-17 age group, 17% in those aged 18-59, and 22% for ages 60-64 was used in the analysis. In total, 2.5 million people were vaccinated in the simulations. Using QIVc instead of QIVe was associated with 16,221fewer symptomatic cases, 4,522 fewer primary care visits, 1,015 fewer emergency room visits and 88 fewer hospitalizations. From a societal perspective, QIVc was more effective and less expensive compared to QIVe, leading to a cost-saving of €3.4 million. From a public payer perspective, the incremental cost-effectiveness ratio for QIVc vs QIVe was €12,852 per QALY gained. In conclusion, QIVc offers a cost-effective alternative to QIVe and should be considered as an alternative vaccine to QIVe for people aged 9-64 at high-risk of influenza complications in Spain.
流感是一种病毒性呼吸道疾病，在全球造成了重大的临床和经济负担。四价流感疫苗（QIV）常用于保护因合并症而有发生流感并发症高风险的人群。QIV可预防甲型流感（A/H1N1和H3N2）以及乙型流感（B/维多利亚系和B/山形系）毒株。欧洲药品管理局最近批准了一种适用于9岁以上人群的细胞培养四价流感疫苗（QIVc）。已证明QIVc在预防流感方面比传统的鸡蛋培养四价流感疫苗（QIVe）更有效。在本研究中，我们使用一个适用于西班牙情况的卫生经济模型，来评估在9至64岁有并发症高风险人群中使用QIVc而非QIVe的成本和结果。分析中采用了观察到的9至17岁年龄组32%、18至59岁年龄组17%以及60至64岁年龄组22%的疫苗接种覆盖率。在模拟中总共为250万人接种了疫苗。使用QIVc而非QIVe可减少16221例有症状病例、4522次初级保健就诊、1015次急诊就诊以及88次住院。从社会角度来看，与QIVe相比，QIVc更有效且成本更低，节省了340万欧元的成本。从公共支付方角度来看，QIVc相对于QIVe的增量成本效益比为每获得一个质量调整生命年（QALY）12852欧元。总之，QIVc是QIVe具有成本效益的替代方案，对于西班牙9至64岁有流感并发症高风险的人群，应将其视为QIVe的替代疫苗。
