OBJECTIVES

Influenza epidemics are annually responsible for a substantial public health and economic burden especially in adults 65 years of age and older (seniors). The need for improved vaccines in this age group is a public health priority. Last year England and Wales recommended the use of a standard dose adjuvanted influenza vaccine (aTIV) in seniors. This year a High Dose trivalent influenza vaccine (TIV High Dose) was approved in the UK and is supported by a substantial body of clinical and economic evidence demonstrating benefit over standard dose vaccines.

The objective of this study is to estimate the cost-effectiveness of TIV High Dose compared to aTIV using clinically relevant endpoints.

METHODS

A static decision tree model was used to compare influenza cases, GP consultations, hospitalisations, and deaths resulting from influenza complications. Two distinct types of influenza complications were considered in separate analyses: 1) hospitalisations explicitly attributed to influenza/pneumonia and 2) hospitalisations due to any respiratory cause. The first analysis is a highly specific but less sensitive in capturing the impact of the vaccine thus it is a conservative analysis for assessing the value of TIV High Dose. QALY losses were included for hospitalisations and in-hospital deaths (discounted at 3.5% per year). Analyses were conducted from UK healthcare system perspective using vaccine list prices. Only seniors were included, and the time horizon was one year.

RESULTS

TIV High Dose was cost-effective compared to aTIV for all scenarios tested, with ICERs of £2,154—8,757 / QALY and £2,800 / QALY for the influenza/pneumonia hospitalisations analysis and the respiratory hospitalisations analysis, respectively. This was largely driven by reduction in hospitalisations (4,637 and 21,129 per year) and associated resource use.

CONCLUSIONS

TIV High Dose would be a highly cost-effective alternative to aTIV in England and Wales and could reduce the annual public health burden of influenza-related complications.