Evaluating the Cost-Effectiveness of Adjuvanted Influenza Vaccine in the Older Adult Population in the Netherlands
Author(s)
Florian Zeevat, PhD, PharmD1, Susan de Braak, MSc1, Joaquin Federico Mould-Quevedo, MBA, MSc, PhD2, Jan Wilschut, PhdD1, Ted van Essen, PhD3, Ab Osterhaus, PhD4, Maarten Jacobus Postma, PhD5.
1Health-Ecore, Utrecht, Netherlands, 2Seqirus, Summit, NJ, USA, 3Dutch Immunisation Foundation, Amersfoort, Netherlands, 4University of Veterinary Medicine, Hannover, Germany, 5University of Groningen, Groningen, Netherlands.
1Health-Ecore, Utrecht, Netherlands, 2Seqirus, Summit, NJ, USA, 3Dutch Immunisation Foundation, Amersfoort, Netherlands, 4University of Veterinary Medicine, Hannover, Germany, 5University of Groningen, Groningen, Netherlands.
OBJECTIVES: In the Netherlands, influenza vaccination is offered to older adults using the standard-dose influenza vaccine (SD-IV). Enhanced vaccines, such as the adjuvanted influenza vaccine (aIV) have demonstrated clinical and economic benefits. This analysis evaluated the cost-effectiveness of aIV compared to SD-IV in adults ≥60 years in the Netherlands.
METHODS: A static decision-tree model was adapted to the Dutch setting to estimate costs and health outcomes associated with using aIV instead of SD-IV. The model simulated a single average influenza season in the period 2013-2020 from a societal perspective. Two incidence scenarios were considered: (A) influenza-specific hospitalizations from a Dutch retrospective observational study and excess-mortality based on national surveillance data, and (B) respiratory ICD-10-coded hospitalizations and in-hospital-mortality from Dutch statistics. Based on a published meta-analysis, a relative vaccine effectiveness (rVE) of 13.7% for aIV versus SD-IV was used, close to the lower bound of the Dutch Health Council’s suggested rVE range for enhanced influenza vaccines versus SD-IV (10-30%). Sensitivity analyses assessed uncertainty, including varying rVE within the Health Council’s range.
RESULTS: Vaccinating individuals aged ≥60 years with aIV instead of SD-IV in an average season in the period 2013-2020 could have avoided ~3,500 GP visits, up to 3,160 hospitalizations, and up to 340 deaths. These health benefits translated into €4.4-28.7 million cost savings and 2,120-2,466 quality-adjusted life years (QALYs) gained, depending on incidence scenario. The incremental cost-effectiveness ratio (ICER) was estimated at €11,400/QALY for influenza-specific hospitalizations, and €46/QALY for all-respiratory hospitalizations. Varying the rVE from 10% to 30% resulted in ICERs ranging from €16,400 to €4,100/QALY (scenario A), and from €5,750/QALY to cost-saving (scenario B).
CONCLUSIONS: With an assumed rVE of 13.7%, replacing SD-IV with aIV in adults aged ≥60 years in the Netherlands would have been a cost-effective strategy, with ICERs consistently below the commonly accepted willingness-to-pay threshold.
METHODS: A static decision-tree model was adapted to the Dutch setting to estimate costs and health outcomes associated with using aIV instead of SD-IV. The model simulated a single average influenza season in the period 2013-2020 from a societal perspective. Two incidence scenarios were considered: (A) influenza-specific hospitalizations from a Dutch retrospective observational study and excess-mortality based on national surveillance data, and (B) respiratory ICD-10-coded hospitalizations and in-hospital-mortality from Dutch statistics. Based on a published meta-analysis, a relative vaccine effectiveness (rVE) of 13.7% for aIV versus SD-IV was used, close to the lower bound of the Dutch Health Council’s suggested rVE range for enhanced influenza vaccines versus SD-IV (10-30%). Sensitivity analyses assessed uncertainty, including varying rVE within the Health Council’s range.
RESULTS: Vaccinating individuals aged ≥60 years with aIV instead of SD-IV in an average season in the period 2013-2020 could have avoided ~3,500 GP visits, up to 3,160 hospitalizations, and up to 340 deaths. These health benefits translated into €4.4-28.7 million cost savings and 2,120-2,466 quality-adjusted life years (QALYs) gained, depending on incidence scenario. The incremental cost-effectiveness ratio (ICER) was estimated at €11,400/QALY for influenza-specific hospitalizations, and €46/QALY for all-respiratory hospitalizations. Varying the rVE from 10% to 30% resulted in ICERs ranging from €16,400 to €4,100/QALY (scenario A), and from €5,750/QALY to cost-saving (scenario B).
CONCLUSIONS: With an assumed rVE of 13.7%, replacing SD-IV with aIV in adults aged ≥60 years in the Netherlands would have been a cost-effective strategy, with ICERs consistently below the commonly accepted willingness-to-pay threshold.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE436
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Disease
Vaccines