Tavares Diana, Mouriño Helena, Rodríguez Cristina Antón, Saborido Carlos Martín
Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal.
Facultad de Medicina, Universidad Francisco de Vitoria Madrid, 28223 Madrid, Spain.
Vaccines (Basel). 2022 Aug 9;10(8):1285. doi: 10.3390/vaccines10081285.
quadrivalent inactivated vaccine (QIV) has replaced trivalent inactivated vaccine (TIV). In Portugal, TIV is free of charge for risk groups, including older adults (≥65 years old). In its turn, QIV-which provides broader protection as it includes an additional lineage B strain-was introduced in Portugal in October 2018; only since the 2019/20 influenza season has it been provided free of charge for risk groups. This study evaluates the cost effectiveness of switching from TIV to QIV, from the National Health Service perspective, in the Portuguese elderly mainland population.
A decision tree model was developed to compare TIV and QIV, based on Portuguese hospitalization data for the 2015/16 influenza season. The primary health economic outcome under consideration was the incremental cost-effectiveness ratio (ICER). In addition, one-way sensitivity analysis and probabilistic sensitivity analysis were performed.
the high cost of QIV (approximately three times the cost of TIV) would lead to a total increment of EUR 5,283,047, and the resulting ICER would be EUR 26,403,007/QALY, above the usual willingness-to-pay threshold.
from the National Health Service perspective, our findings reveal that QIV is not cost effective for the Portuguese elderly population due to the high cost. If the QIV costs were the same as the TIV, then QIV would be cost effective.
四价灭活疫苗（QIV）已取代三价灭活疫苗（TIV）。在葡萄牙，TIV 对包括老年人（≥65 岁）在内的风险群体免费。而 QIV——由于包含额外的 B 系毒株，提供了更广泛的保护——于 2018 年 10 月在葡萄牙引入；仅从 2019/20 流感季节起，它才对风险群体免费提供。本研究从葡萄牙大陆老年人群体的国家卫生服务角度评估从 TIV 转换为 QIV 的成本效益。
基于 2015/16 流感季节的葡萄牙住院数据，开发了一个决策树模型来比较 TIV 和 QIV。所考虑的主要卫生经济结果是增量成本效益比（ICER）。此外，还进行了单因素敏感性分析和概率敏感性分析。
QIV 的高成本（约为 TIV 成本的三倍）将导致总成本增加 5,283,047 欧元，由此产生的 ICER 将为 26,403,007 欧元/QALY，高于通常的支付意愿阈值。
从国家卫生服务角度来看，我们的研究结果表明，由于成本高昂，QIV 对葡萄牙老年人群体不具有成本效益。如果 QIV 的成本与 TIV 相同，那么 QIV 将具有成本效益。
