Sanofi Pasteur, Dubai, United Arab Emirates.
Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Value Health Reg Issues. 2021 Sep;25:15-22. doi: 10.1016/j.vhri.2020.11.006. Epub 2021 Jan 20.
Trivalent influenza vaccines (TIVs) are widely used but protect against only 1 of the 2 co-circulating influenza B virus lineages. Quadrivalent influenza vaccines (QIVs) include a B strain from each lineage to overcome mismatches. The main objective of this study was to determine the cost-utility and budget impact of switching from vaccination with TIV to QIV in the population recommended for influenza vaccination in Turkey.
A static cohort cost-effectiveness model was developed to predict influenza-related costs and outcomes under a QIV versus a TIV program during an influenza season. The model was informed by data from Turkey on influenza strain distribution, influenza-attributable outcomes, and associated costs over the seasons 2010/2011 to 2016/2017. The effectiveness of each strategy was measured through quality-adjusted life-years (QALYs), and comparisons were based on the incremental cost-effectiveness ratio.
In an average influenza season, the model showed that switching from TIV to QIV would prevent an additional 15 092 cases of influenza, 6311 general practitioner visits, 94 hospitalizations, 13 deaths, and gain 440 QALYs. From the societal perspective, this amounted to total cost savings of international dollars (I$) 1102 710 (US$388 643). The incremental cost-effectiveness ratio when using QIV over TIV was I$55 248/QALY gained. Switching to QIV is mostly cost-effective among older adults with I$36 413.38/QALY. Sensitivity analysis showed that vaccine effectiveness, B strain mismatch, and influenza visits highly impact the cost-effectiveness results.
Switching from TIV to QIV is likely to be cost-effective in Turkey, yet highly dependent on the severity of the influenza season, B strain epidemiology, and vaccine effectiveness.
三价流感疫苗（TIV）被广泛使用，但仅能预防两种流行的乙型流感病毒谱系中的一种。四价流感疫苗（QIV）包含来自每个谱系的 B 株，以克服不匹配。本研究的主要目的是确定在土耳其推荐的流感疫苗接种人群中，从 TIV 切换到 QIV 的成本效益和预算影响。
我们开发了一个静态队列成本效益模型，以预测在流感季节期间，QIV 与 TIV 方案下与流感相关的成本和结果。该模型基于土耳其在流感株分布、流感归因结果以及 2010/2011 至 2016/2017 季节相关成本方面的数据。每种策略的有效性通过质量调整生命年（QALY）来衡量，比较是基于增量成本效益比。
在一个平均的流感季节，该模型表明，从 TIV 切换到 QIV 将预防额外的 15092 例流感、6311 次全科医生就诊、94 例住院、13 例死亡，并获得 440 个 QALY。从社会角度来看，这相当于节省国际元（I$）1102710 美元（388643 美元）。与 TIV 相比，使用 QIV 的增量成本效益比为 I$55248/QALY。对于老年人来说，从 TIV 切换到 QIV 最具成本效益，每 QALY 的成本效益为 I$36413.38。敏感性分析表明，疫苗效力、B 株不匹配和流感就诊对成本效益结果影响较大。
在土耳其，从 TIV 切换到 QIV 可能具有成本效益，但高度依赖于流感季节的严重程度、B 株流行病学和疫苗效力。
