COST-EFFECTIVENESS ANALYSIS OF EXPANDING INTRANASAL INFLUENZA VACCINATION IN PAEDIATRIC HIGH-RISK POPULATIONS IN GERMANY
Author(s)
Tabea Nordmeyer, MSc1, Katrin Schöneweis, Dr1, Luca Ricci–Pacifici, MSc2, Fryderyk Wilczynski, MSc2, Maria Herberg, Dr3, Rebekka Mumm, Dr3, Tarcyane Barata Garcia, PhD3, Klas Bergenheim, PhD4, Vera Schipper, Dr1.
1AstraZeneca Germany GmbH, Hamburg, Germany, 2HEOR Ltd., Cardiff, United Kingdom, 3WIG2 Institute GmbH, Leipzig, Germany, 4AstraZeneca, Molndal, Sweden.
1AstraZeneca Germany GmbH, Hamburg, Germany, 2HEOR Ltd., Cardiff, United Kingdom, 3WIG2 Institute GmbH, Leipzig, Germany, 4AstraZeneca, Molndal, Sweden.
OBJECTIVES: Children with chronic conditions are at increased risk of influenza-related complications and contribute substantially to influenza transmission. Despite existing vaccination recommendations, the vaccine coverage rate (VCR) among high-risk children in Germany remains low. This study evaluated the population-level cost-effectiveness of increased VCR with an intranasal live-attenuated influenza vaccine (LAIV) among German paediatric high-risk populations.
METHODS: An age-/risk-stratified dynamic transmission model with a susceptible-exposed-infected-recovered (SEIR) structure, previously applied to Sweden, was redefined to the German healthcare system. The model was calibrated to average non-pandemic influenza seasons and captured effects for direct (high-risk children aged 2-17) and indirect (all other children, adults) populations. The analysis was conducted from a healthcare-payer and societal perspective over a 1-year time horizon. Two intervention scenarios were evaluated increasing VCR in the direct population versus current vaccination practice (VCR 7.95%): (1) doubling VCR to 15.89% and (2) increasing VCR to 38.45%. Outcomes included influenza infections, hospitalizations, quality-adjusted life years (QALYs), payer-related and societal costs, and incremental cost-effectiveness ratios (ICERs).
RESULTS: Intervention scenarios (1) and (2) prevented 160,978 (1) and 541,053 (2) influenza infections and 593 (1) and 1,990 (2) hospitalizations; 738 (1) and 2,479 (2) QALYs were gained. Associated payer-related costs were €1.5 million (1) and €4.1 million (2) with cost-effective ICERs of €1,977 (1) and €1,670 (2) per QALY. Considering (child-)sick-pay or societal costs additionally, both scenarios were cost-saving. Increased LAIV uptake remained cost-effective across sensitivity analyses and varying epidemiological assumptions.
CONCLUSIONS: Increasing uptake of intranasal LAIV among German paediatric high-risk populations was cost-effective with reductions in influenza-related morbidity and societal costs. The predominance of indirect protection effects underscores the importance of dynamic transmission modelling. Findings suggest that broader implementation of LAIV vaccinations may provide considerable public health and economic value. An analysis of effects vaccinating the overall pediatric population is ongoing, results will be presented at the congress.
METHODS: An age-/risk-stratified dynamic transmission model with a susceptible-exposed-infected-recovered (SEIR) structure, previously applied to Sweden, was redefined to the German healthcare system. The model was calibrated to average non-pandemic influenza seasons and captured effects for direct (high-risk children aged 2-17) and indirect (all other children, adults) populations. The analysis was conducted from a healthcare-payer and societal perspective over a 1-year time horizon. Two intervention scenarios were evaluated increasing VCR in the direct population versus current vaccination practice (VCR 7.95%): (1) doubling VCR to 15.89% and (2) increasing VCR to 38.45%. Outcomes included influenza infections, hospitalizations, quality-adjusted life years (QALYs), payer-related and societal costs, and incremental cost-effectiveness ratios (ICERs).
RESULTS: Intervention scenarios (1) and (2) prevented 160,978 (1) and 541,053 (2) influenza infections and 593 (1) and 1,990 (2) hospitalizations; 738 (1) and 2,479 (2) QALYs were gained. Associated payer-related costs were €1.5 million (1) and €4.1 million (2) with cost-effective ICERs of €1,977 (1) and €1,670 (2) per QALY. Considering (child-)sick-pay or societal costs additionally, both scenarios were cost-saving. Increased LAIV uptake remained cost-effective across sensitivity analyses and varying epidemiological assumptions.
CONCLUSIONS: Increasing uptake of intranasal LAIV among German paediatric high-risk populations was cost-effective with reductions in influenza-related morbidity and societal costs. The predominance of indirect protection effects underscores the importance of dynamic transmission modelling. Findings suggest that broader implementation of LAIV vaccinations may provide considerable public health and economic value. An analysis of effects vaccinating the overall pediatric population is ongoing, results will be presented at the congress.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE756
Topic
Economic Evaluation
Disease
Vaccines