HIGH-DOSE INFLUENZA VACCINATION IN OLDER ADULTS: A COST-EFFECTIVENESS REVIEW INCORPORATING BROADER COMPLICATIONS AND HOSPITALIZATION OUTCOMES
Author(s)
Gerald Moncayo, PhD1, Mafalda Nascimento Costa, MSc2, Capucine Chagneau, PharmD3, Arvind Bhushan, MBA4, Marie-Cécile Levant, PharmD1.
1Sanofi, Lyon, France, 2Syneos Health, London, United Kingdom, 3HEOR, Syneos Health, Paris, France, 4Sanofi, Hyderabad, India.
1Sanofi, Lyon, France, 2Syneos Health, London, United Kingdom, 3HEOR, Syneos Health, Paris, France, 4Sanofi, Hyderabad, India.
OBJECTIVES: Influenza imposes a substantial health and economic burden in adults aged ≥65 years, driven by both acute infections and downstream complications. High-dose (HD) influenza vaccines have shown improved protection versus standard-dose (SD) non-adjuvanted vaccines and may offer advantages over adjuvanted vaccines. This review synthesized cost-effectiveness modelling studies comparing HD with SD and adjuvanted vaccines, with emphasis on broader outcomes including respiratory, cardiorespiratory, and all-cause hospitalizations.
METHODS: A targeted literature review conducted in PubMed identified model-based economic evaluations in adults aged ≥65 years. Studies from payer and societal perspectives were included. Outcomes included incremental cost-effectiveness ratios (ICERs), and public health impacts (cases, healthcare utilization, hospitalizations, and deaths).
RESULTS: Thirteen studies from Europe and Asia (including Belgium, Finland, France, Italy, Japan, Netherlands, Portugal, South Korea, Spain, Taiwan, and UK) were included.
Across HD vs SD comparisons, ICERs were consistently below commonly accepted thresholds or cost saving (€1,397-€24,020/QALY in Europe; ¥4.9 million/QALY in Japan; ~$6,500-$7,900/QALY in South Korea). For comparisons between HD and adjuvanted vaccines, studies showed varying economic outcomes depending on modelling assumptions, with HD often meeting cost‑effectiveness thresholds (e.g., Italy, Spain, and England/Wales with ICERs £1,932-£8,767/QALY). Inclusion of broader outcomes, particularly cardiorespiratory hospitalizations, improved cost-effectiveness and in some cases led to HD dominance (Netherlands, Spain). Across studies, reductions in hospitalizations, particularly cardiorespiratory, were the main drivers of results, alongside decreases in influenza cases, healthcare utilization, and deaths (e.g., >4,600 hospitalizations avoided in England/Wales over a single influenza season).
CONCLUSIONS: HD influenza vaccines are consistently cost-effective versus SD non-adjuvanted and frequently versus adjuvanted vaccines. Comparative value versus adjuvanted vaccines is context-dependent and sensitive to assumptions on effectiveness and price. Incorporating broader outcomes substantially strengthens the economic value, supporting the use of HD vaccination to reduce clinical burden and healthcare system pressure in older adults.
METHODS: A targeted literature review conducted in PubMed identified model-based economic evaluations in adults aged ≥65 years. Studies from payer and societal perspectives were included. Outcomes included incremental cost-effectiveness ratios (ICERs), and public health impacts (cases, healthcare utilization, hospitalizations, and deaths).
RESULTS: Thirteen studies from Europe and Asia (including Belgium, Finland, France, Italy, Japan, Netherlands, Portugal, South Korea, Spain, Taiwan, and UK) were included.
Across HD vs SD comparisons, ICERs were consistently below commonly accepted thresholds or cost saving (€1,397-€24,020/QALY in Europe; ¥4.9 million/QALY in Japan; ~$6,500-$7,900/QALY in South Korea). For comparisons between HD and adjuvanted vaccines, studies showed varying economic outcomes depending on modelling assumptions, with HD often meeting cost‑effectiveness thresholds (e.g., Italy, Spain, and England/Wales with ICERs £1,932-£8,767/QALY). Inclusion of broader outcomes, particularly cardiorespiratory hospitalizations, improved cost-effectiveness and in some cases led to HD dominance (Netherlands, Spain). Across studies, reductions in hospitalizations, particularly cardiorespiratory, were the main drivers of results, alongside decreases in influenza cases, healthcare utilization, and deaths (e.g., >4,600 hospitalizations avoided in England/Wales over a single influenza season).
CONCLUSIONS: HD influenza vaccines are consistently cost-effective versus SD non-adjuvanted and frequently versus adjuvanted vaccines. Comparative value versus adjuvanted vaccines is context-dependent and sensitive to assumptions on effectiveness and price. Incorporating broader outcomes substantially strengthens the economic value, supporting the use of HD vaccination to reduce clinical burden and healthcare system pressure in older adults.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE286
Topic
Economic Evaluation, Epidemiology & Public Health, Study Approaches
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Vaccines