Centre for Mathematical Modeling of Infectious Disease, London School of Hygiene and Tropical Medicine, London WC14 7HT, United Kingdom.
Centre for Mathematical Modeling of Infectious Disease, London School of Hygiene and Tropical Medicine, London WC14 7HT, United Kingdom.
Vaccine. 2023 Sep 22;41(41):6017-6024. doi: 10.1016/j.vaccine.2023.08.031. Epub 2023 Aug 24.
Next generation influenza vaccines are in development and have the potential for widespread health and economic benefits. Determining the potential health and economic impact for these vaccines is needed to drive investment in bringing these vaccines to the market, and to inform which groups public health policies on influenza vaccination should target. We used a mathematical modelling approach to estimate the epidemiological impact and cost-effectiveness of next generation influenza vaccines in England and Wales. We used data from an existing fitted model, and evaluated new vaccines with different characteristics ranging from improved vaccines with increased efficacy duration and breadth of protection, to universal vaccines, defined in line with the World Health Organisation (WHO) Preferred Product Characteristics (PPC). We calculated the cost effectiveness of new vaccines in comparison to the current seasonal vaccination programme. We calculated and compared the Incremental Cost-Effectiveness Ratio and Incremental Net Monetary Benefit for each new vaccine type. All analysis was conducted in R. We show that next generation influenza vaccines may result in a 21% to 77% reduction in influenza infections, dependent on vaccine characteristics. Our economic modelling shows that using any of these next generation vaccines at 2019 coverage levels would be highly cost-effective at a willingness to pay threshold of £20,000 for a range of vaccine prices. The vaccine threshold price for the best next generation vaccines in £-2019 is £230 (95%CrI £192 - £269) per dose, but even minimally-improved influenza vaccines could be priced at £18 (95%CrI £16 - £21) per dose and still remain cost-effective. This evaluation demonstrates the promise of next generation influenza vaccines for impact on influenza epidemics, and likely cost-effectiveness profiles. We have provided evidence towards a full value of vaccines assessment which bolsters the investment case for development and roll-out of next-generation influenza vaccines.
下一代流感疫苗正在研发中，具有广泛的健康和经济效益。为了推动这些疫苗进入市场的投资，并为流感疫苗接种的公共卫生政策确定目标人群，需要确定这些疫苗的潜在健康和经济影响。我们使用数学模型方法来估计下一代流感疫苗在英格兰和威尔士的流行病学影响和成本效益。我们使用了现有拟合模型的数据，并评估了具有不同特征的新型疫苗，这些疫苗的特征包括功效持续时间和保护范围增加的改良疫苗，以及按照世界卫生组织（WHO）优先产品特征（PPC）定义的通用疫苗。我们将新疫苗与当前季节性疫苗接种计划进行了成本效益比较。我们计算了每种新型疫苗的增量成本效益比和增量净货币收益，并进行了比较。所有分析均在 R 中进行。我们表明，下一代流感疫苗可能会使流感感染减少 21%至 77%，具体取决于疫苗的特征。我们的经济模型表明，在 2019 年的疫苗接种水平下，使用这些下一代疫苗中的任何一种，在 20,000 英镑的意愿支付阈值下，对于一系列疫苗价格都是高度具有成本效益的。2019 年最佳下一代疫苗的疫苗门槛价格为每剂 230 英镑（95%CrI 219-269 英镑），但即使是功效略有改善的流感疫苗，每剂也可以定价 18 英镑（95%CrI 16-21 英镑），并且仍然具有成本效益。这项评估表明，下一代流感疫苗在流感流行方面具有巨大的潜力，并且可能具有成本效益。我们已经提供了下一代流感疫苗全面价值评估的证据，这为下一代流感疫苗的开发和推广提供了投资案例。
