Kohli Michele A, Maschio Michael, Cartier Shannon, Mould-Quevedo Joaquin, Fricke Frank-Ulrich
Quadrant Health Economics Inc., 92 Cottonwood Crescent, Cambridge, ON N1T 2J1, Canada.
Seqirus USA Inc., 25 Deforest Avenue, Summit, NJ 07901, USA.
Vaccines (Basel). 2022 Aug 25;10(9):1386. doi: 10.3390/vaccines10091386.
Enhanced quadrivalent influenza vaccines that include an adjuvant (aQIV) or a high dose of antigen (QIV-HD), which stimulate a stronger immune response in older adults than the standard vaccine (QIVe), are now approved. The objective of this research is to compare available vaccines and determine the cost-effectiveness of immunizing persons aged 65 years and above with aQIV compared to QIVe and QIV-HD in Germany. A compartmental transmission model calibrated to outpatient visits for influenza in Germany was used to predict the number of medically attended infections using the three vaccines. The rates of hospitalizations, deaths, and other economic consequences were estimated with a decision tree using German data where available. Based on meta-analysis, the rVE of -2.5% to 8.9% for aQIV versus QIV-HD, the vaccines are similar clinically, but aQIV is cost saving compared to QIV-HD (unit cost of EUR 40.55). All results were most sensitive to changes in vaccine effectiveness. aQIV may be cost-effective compared to QIVe depending on the willingness to pay for additional benefits in Germany. As aQIV and QIV-HD are similar in terms of effectiveness, aQIV is cost saving compared to QIV-HD at current unit prices.
现已批准的增强型四价流感疫苗，包括含有佐剂的四价流感疫苗（aQIV）或高剂量抗原的四价流感疫苗（QIV-HD），在老年人中能比标准疫苗（QIVe）激发更强的免疫反应。本研究的目的是比较现有的疫苗，并确定在德国65岁及以上人群中，与QIVe和QIV-HD相比，接种aQIV的成本效益。使用根据德国流感门诊就诊情况校准的房室传播模型来预测使用这三种疫苗的医疗就诊感染人数。在可获得德国数据的情况下，使用决策树估计住院率、死亡率和其他经济后果。基于荟萃分析，aQIV相对于QIV-HD的相对疫苗效力（rVE）为-2.5%至8.9%，这两种疫苗在临床上相似，但与QIV-HD相比，aQIV具有成本效益（单位成本为40.55欧元）。所有结果对疫苗效力的变化最为敏感。在德国，根据为额外益处支付费用的意愿，与QIVe相比，aQIV可能具有成本效益。由于aQIV和QIV-HD在效力方面相似，按当前单价计算，aQIV比QIV-HD更具成本效益。
