Cost-effectiveness analysis of switching from a trivalent to a quadrivalent inactivated influenza vaccine in the Peruvian immunisation programme. Issue 30 (5th July 2021)

• Record Type: Journal Article
• Authors: Bellier, Lucile; Petitjean, Audrey; Sarazu, Tatiana; Tresierra, Julio; Lopez, Juan Guillermo
• Is Part Of: Vaccine. Volume 39:Issue 30(2021)
• Page Start: 4144
• Page End: 4152
• Publication Date: 2021-07-05
• Subjects: Influenza -- Vaccination -- Switch to quadrivalent influenza vaccine -- Cost-effectiveness -- Decision-analytic model -- Peru; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2021.05.084
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Vaccination coverage rate is low in the Influenza vaccination programme in Peru. Quadrivalent inactivated influenza vaccine protects against four influenza viruses. Switching from TIV to QIV would reduce the number of Influenza B's cases and deaths. Switching from TIV to QIV would result in savings for the healthcare payer. A switch from QIV to TIV in Peru is considered to be a cost-effective strategy. Abstract: Background: Seasonal influenza is an acute respiratory infection mostly caused by type A and B influenza viruses. The severe form of the infection can be life-threatening and lead to a significant burden. Vaccination is the most efficient way of preventing influenza infections and limit this burden. Objectives: To assess the cost-effectiveness of switching from a trivalent influenza vaccine (TIV) to a quadrivalent influenza vaccine (QIV) in the vaccination programme in Peru, and to evaluate the health and economic impact of reaching the vaccination coverage rate targeted by the Ministry of Health. Methods: A decision-analytic static cost-effectiveness model, was adapted to the Peruvian setting under both payer and societal perspectives. Results: A switch from TIV to QIV would prevent 29, 126 additional cases (including 12, 815 consultations), 54 hospitalisations, and 23 deaths related to influenza, mostly in the population <2 years-old and >60 years-old. This would lead to a saving of US $505, 206 under the payer perspective, that would partially offset the investment necessary to introduce QIV into the immunisation programme. The resulting incremental cost-effectiveness ratio (ICER) is $16, 649 per QALYs gained. The main drivers of the model results were vaccine efficacy against influenza B viruses, degree of match, vaccines prices and proportion of cases attributable to influenza B. The robustness of the results seems satisfactory as QIV has the probability of being a cost-effective strategy of 83.8% (considering a threshold of three GDP per capita). Reaching the coverage targeted by the Ministry of Health would result in health benefits and disease management savings, and lower ICERs. Conclusion: Introducing QIV instead of TIV in the Peruvian immunisation programme is expected to be a cost-effective strategy, especially in younger children and the elderly. The benefit of QIV would be even more important if the coverage targeted by the Ministry of Health would be reached in the most vulnerable groups.