COST-EFFECTIVENESS OF INFLUENZA VACCINE IN REDUCING HOSPITALIZATIONS AND MORTALITY IN THE ELDERLY POPULATION IN INDIA...
Author(s)
Dhaval Parmar, PhD1, Jigna Gohil, MD1, Devang R. Raval, Sr., MPH1, Somen Saha, PhD1, Raju Sarkar, PhD1, Archana Thakur, MD1, Junaid KP, PhD1, Krushnachandra Sahoo, PhD2, Deepak B Saxena, PhD1, Kavitha Rajsekar, PhD2.
1Indian Institute of Public Health Gandhinagar, Gandhinagar, India, 2Department of health Research, MoHFW, New Delhi, India.
1Indian Institute of Public Health Gandhinagar, Gandhinagar, India, 2Department of health Research, MoHFW, New Delhi, India.
OBJECTIVES: Influenza causes significant morbidity and mortality among India’s rapidly growing elderly population. Annual influenza vaccination offers critical protection. This study assesses the cost-effectiveness of influenza vaccination in Indian adults aged ≥65 years by modelling reductions in ILI and SARI incidence, estimating quality-adjusted life years (QALYs) gained, and calculating incremental cost-effectiveness ratios (ICER).
METHODS: A static decision tree model was developed with a one-year time horizon to evaluate health outcomes of influenza and incorporated long-term mortality benefits. Model inputs were derived from a three-year community-based surveillance study in India, WHO-led LMIC vaccine-effectiveness data, and health system cost estimates. The analysis was conducted from the health system perspective, assuming 50% vaccination coverage. Incremental cost-effectiveness ratios were compared against a willingness-to-pay threshold of ₹2,34,859 per QALY gained. Budget impact was also estimated at the district and national levels to assess fiscal feasibility.
RESULTS: At 50% influenza vaccine coverage for 54.7 million elderly individuals, the model projected annual reductions of 147,774 (25.2%) ILI cases, 24,662 (27.0%) SARI hospitalizations, 3,471 (32.7%) SARI-IPD deaths, and 6,993 (38.5%) SARI-ICU deaths. QALY loss per 1,000 elderly declined from 4.364 to 2.786, yielding a gain of 1.578 QALYs. Health system costs excluding vaccination are projected to decrease from ₹1,31,120 to ₹92,035 per 1,000 individuals; however, including vaccination costs is projected to increase total expenditures to ₹4,92,695 per 1,000. At an ICER of ₹2,29,154 per QALY gained, the influenza vaccine is expected to be below the threshold value for cost-effectiveness. However, at an estimated budget impact of ₹5.1 crore per district and ₹4,379 crore nationally, there is a need for vaccine price reduction.
CONCLUSIONS: Influenza vaccination in India’s elderly is a cost-effective intervention that substantially reduces influenza morbidity and mortality. Vaccine pricing is pivotal for program affordability and sustainability, supporting the integration of influenza vaccination into India’s national immunization policy for older adults.
METHODS: A static decision tree model was developed with a one-year time horizon to evaluate health outcomes of influenza and incorporated long-term mortality benefits. Model inputs were derived from a three-year community-based surveillance study in India, WHO-led LMIC vaccine-effectiveness data, and health system cost estimates. The analysis was conducted from the health system perspective, assuming 50% vaccination coverage. Incremental cost-effectiveness ratios were compared against a willingness-to-pay threshold of ₹2,34,859 per QALY gained. Budget impact was also estimated at the district and national levels to assess fiscal feasibility.
RESULTS: At 50% influenza vaccine coverage for 54.7 million elderly individuals, the model projected annual reductions of 147,774 (25.2%) ILI cases, 24,662 (27.0%) SARI hospitalizations, 3,471 (32.7%) SARI-IPD deaths, and 6,993 (38.5%) SARI-ICU deaths. QALY loss per 1,000 elderly declined from 4.364 to 2.786, yielding a gain of 1.578 QALYs. Health system costs excluding vaccination are projected to decrease from ₹1,31,120 to ₹92,035 per 1,000 individuals; however, including vaccination costs is projected to increase total expenditures to ₹4,92,695 per 1,000. At an ICER of ₹2,29,154 per QALY gained, the influenza vaccine is expected to be below the threshold value for cost-effectiveness. However, at an estimated budget impact of ₹5.1 crore per district and ₹4,379 crore nationally, there is a need for vaccine price reduction.
CONCLUSIONS: Influenza vaccination in India’s elderly is a cost-effective intervention that substantially reduces influenza morbidity and mortality. Vaccine pricing is pivotal for program affordability and sustainability, supporting the integration of influenza vaccination into India’s national immunization policy for older adults.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE110
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
STA: Vaccines