title: The potential economic value of a 'universal' (multi-year) influenza vaccine.
abstract: BACKGROUND
  Limitations of the current annual influenza vaccine have led to ongoing efforts to develop a 'universal' influenza vaccine, i.e., one that targets a ubiquitous portion of the influenza virus so that the coverage of a single vaccination can persist for multiple years.
  
  
  OBJECTIVE
  To estimate the economic value of a 'universal' influenza vaccine compared to the standard annual influenza vaccine, starting vaccination in the pediatric population (2-18 year olds), over the course of their lifetime.
  
  
  METHODS
  Monte Carlo decision analytic computer simulation model.
  
  
  RESULTS
  Universal vaccine dominates (i.e., less costly and more effective) the annual vaccine when the universal vaccine cost ≤ $100/dose and efficacy ≥ 75% for both the 5- and 10-year duration. The universal vaccine is also dominant when efficacy is ≥ 50% and protects for 10 years. A $200 universal vaccine was only cost-effective when ≥ 75% efficacious for a 5-year duration when annual compliance was 25% and for a 10-year duration for all annual compliance rates. A universal vaccine is not cost-effective when it cost $200 and when its efficacy is ≤ 50%. The cost-effectiveness of the universal vaccine increases with the duration of protection.
  
  
  CONCLUSIONS
  Although development of a universal vaccine requires surmounting scientific hurdles, our results delineate the circumstances under which such a vaccine would be a cost-effective alternative to the annual influenza vaccine.
authors.affiliation: Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. byl1@pitt.edu
authors.forename: Bruce Y
authors.initials: BY
authors.lastname: Lee
authors.forename: Julie H Y
authors.initials: JH
authors.lastname: Tai
authors.forename: Sarah M
authors.initials: SM
authors.lastname: McGlone
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Bailey
authors.forename: Angela R
authors.initials: AR
authors.lastname: Wateska
authors.forename: Shanta M
authors.initials: SM
authors.lastname: Zimmer
authors.forename: Richard K
authors.initials: RK
authors.lastname: Zimmerman
authors.forename: Michael M
authors.initials: MM
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000191:economics*; D007251:Influenza, Human / Q000191:economics* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009010:Monte Carlo Method; D014611:Vaccination / Q000191:economics; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines