Potential Public Health Benefits of Recombinant Influenza Vaccines in Older Adults in England and Wales
Author(s)
Mersha Chetty, Ph.D1, Gerald Moncayo, Ph.D2, Tiziano Poletti, Ph.D1, Kevin Ottino, MSc3, Sarah M. Medland, BSc4, Stuart J. Mealing, MSc4, Jonathan S Nguyen-Van-Tam, MD5.
1Sanofi Vaccines, Berkshire, United Kingdom, 2Sanofi Vaccines, Lyon, France, 3Avalere Health, Boston, MA, USA, 4York Health Economics Consortium, York, United Kingdom, 5School of Medicine, University of Nottingham, Nottingham, United Kingdom.
1Sanofi Vaccines, Berkshire, United Kingdom, 2Sanofi Vaccines, Lyon, France, 3Avalere Health, Boston, MA, USA, 4York Health Economics Consortium, York, United Kingdom, 5School of Medicine, University of Nottingham, Nottingham, United Kingdom.
OBJECTIVES: Annually, the Joint Committee on Vaccination and Immunisation and NHS England issue guidance to primary care practitioners on recommended influenza vaccines. For the forthcoming season (2025-26), three enhanced vaccines, namely recombinant influenza vaccine (RIV), adjuvanted inactivated influenza vaccine (aIIV) and high-dose inactivated influenza vaccine were recommended for older adults (aged over 65 years). Given the longer market presence and published effectiveness data of RIV and aIIV in the local context, this study evaluates the public health impact and cost-effectiveness of these two vaccines in older adults in England and Wales.
METHODS: A static decision-tree model was developed to assess health outcomes for each vaccination strategy, over a single influenza season. The model has two pathways: First, relative vaccine efficacy against laboratory-confirmed influenza cases estimates outpatient burden. Second, local vaccine effectiveness from UKHSA (2022-2024) against hospitalisations determines inpatient burden and mortality. Multiple scenario analyses examined variations in vaccine effectiveness against hospitalisation based on different seasons (2022/23 and 2023/24). Deterministic and probabilistic sensitivity analyses explored variations in parameters. Incremental cost-effectiveness ratios and net-monetary benefits (NMB) were assessed from a healthcare payer perspective.
RESULTS: In the base case analysis, implementing RIV instead of aIIV averted 102,398 influenza cases, 21,508 general practitioner (GP) visits, 6,714 emergency department (ED) visits, 2,540 hospitalisations, and 520 deaths annually. RIV demonstrated savings in terms of influenza-associated prescription medication costs (£212,930), GP visit costs (£2,908,966), reduced ED presentation costs (£2,786,177), and hospitalisation costs (£24,939,466). RIV dominated aIIV with incremental cost savings of £2.69 per person, resulting in an incremental NMB of £10.76 per person. Scenario analyses demonstrated robustness across various assumptions, with RIV consistently dominating aIIV.
CONCLUSIONS: RIV could deliver substantial public health benefits and economic value compared to aIIV for older adults in England and Wales.
METHODS: A static decision-tree model was developed to assess health outcomes for each vaccination strategy, over a single influenza season. The model has two pathways: First, relative vaccine efficacy against laboratory-confirmed influenza cases estimates outpatient burden. Second, local vaccine effectiveness from UKHSA (2022-2024) against hospitalisations determines inpatient burden and mortality. Multiple scenario analyses examined variations in vaccine effectiveness against hospitalisation based on different seasons (2022/23 and 2023/24). Deterministic and probabilistic sensitivity analyses explored variations in parameters. Incremental cost-effectiveness ratios and net-monetary benefits (NMB) were assessed from a healthcare payer perspective.
RESULTS: In the base case analysis, implementing RIV instead of aIIV averted 102,398 influenza cases, 21,508 general practitioner (GP) visits, 6,714 emergency department (ED) visits, 2,540 hospitalisations, and 520 deaths annually. RIV demonstrated savings in terms of influenza-associated prescription medication costs (£212,930), GP visit costs (£2,908,966), reduced ED presentation costs (£2,786,177), and hospitalisation costs (£24,939,466). RIV dominated aIIV with incremental cost savings of £2.69 per person, resulting in an incremental NMB of £10.76 per person. Scenario analyses demonstrated robustness across various assumptions, with RIV consistently dominating aIIV.
CONCLUSIONS: RIV could deliver substantial public health benefits and economic value compared to aIIV for older adults in England and Wales.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE612
Topic
Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Vaccines