Cost Utility Analysis of Influenza Vaccine Among People Aged 50 Years and Older Living with Comorbidities in Egypt

OBJECTIVES: Influenza is a significant public health concern; However, in Egypt influenza vaccination rates remain relatively low. In this study, we aim to evaluate the economic and public health impact associated with the introduction of the quadrivalent Influenza vaccine (QIV) up to a coverage of 75% among high-risk population from a public payer perspective in Egypt.

METHODS: A static decision-analytic model was used to assess the cost-utility of up to 75% coverage vs no vaccination among subjects aged over 50 years old, living with comorbidities such as diabetes, cardiovascular and respiratory chronic diseases. The model parameters and assumptions were obtained from published local data, global literature, and expert opinion. Outcomes data were driven from published Egyptian epidemiological studies. The average cost of influenza was generated via a cost-of-illness model calculated in year 2023 leveraging published data, public price lists, and expert opinion. Population utility norm, QALY loss due to influenza, and QIV vaccine efficacy were obtained from global literature. A discount rate of 3.5% was applied. Time horizon was one average influenza season. One-way and probabilistic sensitivity analyses were performed to test model robustness

RESULTS: The introduction of QIV with a 75% coverage within the public payer target group would result in the avoidance of 221,915 cases of influenza, 43,970 outpatient consultations, 671 hospitalizations, 93 deaths and would generate 6,259 of gained QALYs. The introduction of QIV would lead to an incremental cost utility ratio of EGP 41,061 per QALY, which is below one GDP per capita in Egypt. Sensitivity analysis confirmed model robustness.

CONCLUSIONS: QIV might be considered a cost-effective solution for high-risk older adults in Egypt. The results of this model would inform Egyptian decision makers and payers for efficient resources allocation in influenza prevention.