Cost-Effectiveness Analysis of Seasonal Influenza Vaccination in UAE and Iraq

OBJECTIVES: Influenza is frequently viewed as a trivial illness due to its typically mild symptoms. However, this overlooks the extensive scale of patients affected each year, with a considerable number of cases escalating to severe complications and requiring hospitalization. Globally, influenza causes an estimated 650,000 deaths annually. To date, vaccination remains the most effective strategy for mitigating the impact of influenza. This study examines the cost-effectiveness of influenza vaccination within the United Arab Emirates and Iraq, offering insights into their potential to improve public health outcomes in the region.

METHODS: Our study employs a static individual patient simulation decision tree model, running over a lifetime horizon to simulate two scenarios for each patient: one with influenza vaccination and one without. The model factors in individual characteristics such as age, sex, chronic health conditions, and specific risk groups to determine the chance of infection. Depending on these factors, if a patient becomes infected, their journey can range from outpatient care to ICU admission, and, in extreme instances, death.

RESULTS: Vaccination proved to be cost-effective for the general population in the UAE, whereas in Iraq, vaccination demonstrated dominance. Our analysis reveals significant reductions in hospitalizations and deaths, underlining the vaccine's potential to alleviate the burden. In high-risk patients (patients with chronic conditions and/or risk factors), the vaccine was dominant in all age groups in both countries. Subgroup analysis revealed that the vaccine was cost-effective even for non-high-risk patients across the majority of age groups and even showed dominance in both countries in the 0-4 years and above 65 years age groups.

CONCLUSIONS: This study underscores the importance of expanding vaccination strategies, especially for high-risk populations. Through a detailed analysis of the vaccine's cost-effectiveness, local insights for policymakers are provided to optimize vaccination strategies more effectively in the region.