Cost-effectiveness of dual influenza and pneumococcal vaccination among the elderly in Shenzhen, China. Issue 16 (15th April 2021)

• Record Type: Journal Article
• Authors: Chen, Daqin; Ye, Zhaojia; Pi, Zhenfei; Mizukami, Satoshi; Aoyagi, Kiyoshi; Jiang, Yawen
• Is Part Of: Vaccine. Volume 39:Issue 16(2021)
• Page Start: 2237
• Page End: 2245
• Publication Date: 2021-04-15
• Subjects: IPD invasive pneumococcal disease -- PPSV23 23-valent pneumococcal polysaccharide vaccine -- QALY quality-adjusted life-year -- CI confidence interval -- WHO World Health Organization -- OTC over-the-counter -- ICER incremental cost-effectiveness ratio -- GDP gross domestic product -- WTP willingness-to-pay -- NMB net monetary benefit -- OWSA one-way sensitivity analyses -- PSA probabilistic sensitivity analyses -- VE vaccine effectiveness; Cost-effectiveness -- Markov model -- Influenza -- Pneumonia -- Vaccine; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2021.03.041
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Evidence on the cost-effectiveness of subsidized vaccination programs is important. Dual influenza and pneumococcal vaccination is cost-effective among Shenzhen elderly. Similar dual vaccination programs should be considered elsewhere in China. Abstract: Objective: To assess the cost-effectiveness of dual influenza and pneumococcal vaccination for the elderly in Shenzhen, China. Methods: A Markov state-transition model with a weekly cycle was developed to compare the outcomes of dual influenza and pneumococcal vaccination for the prevention of influenza and pneumococcal infections compared with no vaccination among 70–74 years old people in Shenzhen over 5 years. The model allowed seasonal variation of influenza activity. We calculated the incremental cost-effectiveness ratio (ICER) with costs and quality-adjusted life years (QALYs) discounted at 5% annually from the societal perspective. The impact of parameter uncertainty on the results was examined using one-way and probabilistic sensitivity analyses (PSA). Results: In the base case, dual vaccination prevented 5042 influenza infections, 26 IPD cases, 3 disabilities, 34 deaths, and cost US$7.1 per person while resulting in a net gain of 0.0026 QALYs compared with no vaccination. Using once the Chinese gross domestic product per capita in 2019 (US$10, 289) as the willingness-to-pay threshold, dual vaccination was cost-effective with an ICER of US$2699 per QALY gained. One-way sensitivity analyses showed that the ICER was relatively sensitive to changes in influenza attack rates and influenza vaccine effectiveness. Based on the results of PSA with 1000 Monte Carlo simulations, receiving both vaccines was cost-effective in 100% of the repetitions. Conclusion: The current study provides evidence that dual influenza and pneumococcal vaccination is a cost-effective disease prevention strategy for the elderly in Shenzhen, China.