Cargando…
Potential Cost-Effectiveness of a Universal Influenza Vaccine in Older Adults
BACKGROUND AND OBJECTIVES: “Universal” vaccines that could have multistrain and multiyear effectiveness are being developed. Their potential cost-effectiveness in geriatric populations is unknown. RESEARCH DESIGN AND METHODS: A Markov model estimated effects of a theoretical universal influenza vacc...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293081/ https://www.ncbi.nlm.nih.gov/pubmed/30569023 http://dx.doi.org/10.1093/geroni/igy035 |
_version_ | 1783380490495983616 |
---|---|
author | France, Glenson Wateska, Angela R Nowalk, Mary Patricia DePasse, Jay Raviotta, Jonathan M Shim, Eunha Zimmerman, Richard K Smith, Kenneth J |
author_facet | France, Glenson Wateska, Angela R Nowalk, Mary Patricia DePasse, Jay Raviotta, Jonathan M Shim, Eunha Zimmerman, Richard K Smith, Kenneth J |
author_sort | France, Glenson |
collection | PubMed |
description | BACKGROUND AND OBJECTIVES: “Universal” vaccines that could have multistrain and multiyear effectiveness are being developed. Their potential cost-effectiveness in geriatric populations is unknown. RESEARCH DESIGN AND METHODS: A Markov model estimated effects of a theoretical universal influenza vaccine compared with available seasonal vaccines in hypothetical cohorts of U.S. 65+-year olds followed over a 5-year time horizon to capture potential multiyear protection. Outcomes included costs per quality-adjusted life-year gained and influenza cases avoided. RESULTS: Using hypothetical universal vaccine parameter values (cost $100, vaccine effectiveness 39%, uptake 64%, effectiveness duration 5 years), universal vaccine was less costly than seasonal influenza vaccination strategies. High-dose trivalent influenza vaccine, compared with universal vaccine, gained 0.0028 quality-adjusted life-years and cost $82 more, or $28,700 per quality-adjusted life-year gained. Other seasonal vaccines were not favorable economically. Five-year influenza risk with universal vaccination was 32.3% under base case assumptions, compared with <30% with adjuvanted or high-dose vaccine use. In sensitivity analyses, universal vaccine was favored when uptake or vaccine effectiveness was greater than standard-dose influenza vaccine. If absolute universal vaccine effectiveness was 10% less than standard-dose vaccine, universal vaccine could be cost-saving but not more effective than other strategies. Universal vaccine was not favored if its effectiveness duration was <3 years. DISCUSSION AND IMPLICATIONS: Universal vaccine use in older persons could be either cost effective or cost saving when universal vaccine parameters are within plausible ranges. However, if its effectiveness is substantially less than current vaccines, its use would probably not be favored in geriatric populations. |
format | Online Article Text |
id | pubmed-6293081 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-62930812018-12-19 Potential Cost-Effectiveness of a Universal Influenza Vaccine in Older Adults France, Glenson Wateska, Angela R Nowalk, Mary Patricia DePasse, Jay Raviotta, Jonathan M Shim, Eunha Zimmerman, Richard K Smith, Kenneth J Innov Aging Original Report BACKGROUND AND OBJECTIVES: “Universal” vaccines that could have multistrain and multiyear effectiveness are being developed. Their potential cost-effectiveness in geriatric populations is unknown. RESEARCH DESIGN AND METHODS: A Markov model estimated effects of a theoretical universal influenza vaccine compared with available seasonal vaccines in hypothetical cohorts of U.S. 65+-year olds followed over a 5-year time horizon to capture potential multiyear protection. Outcomes included costs per quality-adjusted life-year gained and influenza cases avoided. RESULTS: Using hypothetical universal vaccine parameter values (cost $100, vaccine effectiveness 39%, uptake 64%, effectiveness duration 5 years), universal vaccine was less costly than seasonal influenza vaccination strategies. High-dose trivalent influenza vaccine, compared with universal vaccine, gained 0.0028 quality-adjusted life-years and cost $82 more, or $28,700 per quality-adjusted life-year gained. Other seasonal vaccines were not favorable economically. Five-year influenza risk with universal vaccination was 32.3% under base case assumptions, compared with <30% with adjuvanted or high-dose vaccine use. In sensitivity analyses, universal vaccine was favored when uptake or vaccine effectiveness was greater than standard-dose influenza vaccine. If absolute universal vaccine effectiveness was 10% less than standard-dose vaccine, universal vaccine could be cost-saving but not more effective than other strategies. Universal vaccine was not favored if its effectiveness duration was <3 years. DISCUSSION AND IMPLICATIONS: Universal vaccine use in older persons could be either cost effective or cost saving when universal vaccine parameters are within plausible ranges. However, if its effectiveness is substantially less than current vaccines, its use would probably not be favored in geriatric populations. Oxford University Press 2018-12-14 /pmc/articles/PMC6293081/ /pubmed/30569023 http://dx.doi.org/10.1093/geroni/igy035 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Report France, Glenson Wateska, Angela R Nowalk, Mary Patricia DePasse, Jay Raviotta, Jonathan M Shim, Eunha Zimmerman, Richard K Smith, Kenneth J Potential Cost-Effectiveness of a Universal Influenza Vaccine in Older Adults |
title | Potential Cost-Effectiveness of a Universal Influenza Vaccine in Older Adults |
title_full | Potential Cost-Effectiveness of a Universal Influenza Vaccine in Older Adults |
title_fullStr | Potential Cost-Effectiveness of a Universal Influenza Vaccine in Older Adults |
title_full_unstemmed | Potential Cost-Effectiveness of a Universal Influenza Vaccine in Older Adults |
title_short | Potential Cost-Effectiveness of a Universal Influenza Vaccine in Older Adults |
title_sort | potential cost-effectiveness of a universal influenza vaccine in older adults |
topic | Original Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293081/ https://www.ncbi.nlm.nih.gov/pubmed/30569023 http://dx.doi.org/10.1093/geroni/igy035 |
work_keys_str_mv | AT franceglenson potentialcosteffectivenessofauniversalinfluenzavaccineinolderadults AT wateskaangelar potentialcosteffectivenessofauniversalinfluenzavaccineinolderadults AT nowalkmarypatricia potentialcosteffectivenessofauniversalinfluenzavaccineinolderadults AT depassejay potentialcosteffectivenessofauniversalinfluenzavaccineinolderadults AT raviottajonathanm potentialcosteffectivenessofauniversalinfluenzavaccineinolderadults AT shimeunha potentialcosteffectivenessofauniversalinfluenzavaccineinolderadults AT zimmermanrichardk potentialcosteffectivenessofauniversalinfluenzavaccineinolderadults AT smithkennethj potentialcosteffectivenessofauniversalinfluenzavaccineinolderadults |