Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
Essener Forschungsinstitut für Medizinmanagement (EsFoMed) GmbH, Bredeneyer Str. 2b, 45133, Essen, Germany.
Pharmacoeconomics. 2023 Nov;41(11):1539-1550. doi: 10.1007/s40273-023-01299-y. Epub 2023 Jul 11.
In Germany, influenza vaccination is mainly advised for persons aged 60 years and over and individuals with health risks. Since 2021, an inactivated, quadrivalent high-dose influenza vaccine (IIV4-HD) has been recommended for persons aged 60 years and over. The aim of this study was to calculate the impact of vaccinating the German population aged 60 years and over with IIV4-HD compared to standard-dose influenza vaccines (IIV4-SD) with regard to health outcomes and costs.
An age-stratified deterministic compartment model was built to simulate the course of influenza infection for the German population in the season 2019/20. Probabilities for health outcomes and cost data were searched from the literature and were used to compare the influenza-related health and economic effects for different scenarios. Perspectives were those of the statutory health insurance and the society. Deterministic sensitivity analyses were conducted.
From the statutory health insurance perspective, vaccinating the German population aged 60 years and over with IIV4-HD would have prevented 277,026 infections (- 1.1%) with an increase of overall direct costs of €224 million (+ 40.1%) compared with IIV4-SD. A separate analysis showed that increased vaccination of 75% (World Health Organization recommendation for older age groups) in persons aged 60 years and over using IIV4-SD only would prevent 1,289,648 infections (- 5.1%) and would save costs from a statutory health insurance perspective of €103 million (- 13.2%) compared with IIV4-HD at actual vaccination rates.
The modeling approach offers important insights into the epidemiological and budgetary impact of different vaccination scenarios. Achieving a higher vaccination coverage with IIV4-SD in persons aged 60 years and over would result in lower costs and fewer influenza infections compared with the scenario with IIV4-HD and actual vaccination rates.
在德国，流感疫苗主要建议接种人群为 60 岁及以上人群和存在健康风险的人群。自 2021 年以来，一种灭活、四价、高剂量流感疫苗（IIV4-HD）已被推荐用于 60 岁及以上人群。本研究旨在计算为 60 岁及以上人群接种 IIV4-HD 而非标准剂量流感疫苗（IIV4-SD）对健康结果和成本的影响。
建立了一个分层年龄的确定性 compartment 模型，以模拟 2019/20 年德国人群的流感感染过程。从文献中检索健康结果和成本数据的概率，并用于比较不同情况下与流感相关的健康和经济影响。视角是法定健康保险和社会的视角。进行了确定性敏感性分析。
从法定健康保险的角度来看，与 IIV4-SD 相比，为 60 岁及以上人群接种 IIV4-HD 可预防 277,026 例感染（-1.1%），并增加总直接成本 2.24 亿欧元（+40.1%）。单独分析表明，仅对 60 岁及以上人群进行 75%（世界卫生组织对老年人群的建议）的额外疫苗接种，使用 IIV4-SD 可预防 1,289,648 例感染（-5.1%），并从法定健康保险的角度节省 1.03 亿欧元的成本（-13.2%），而实际接种率下使用 IIV4-HD。
该建模方法提供了对不同疫苗接种方案的流行病学和预算影响的重要见解。与 IIV4-HD 实际接种率相比，在 60 岁及以上人群中使用 IIV4-SD 提高疫苗接种覆盖率将降低成本并减少流感感染。
