High-dose inactivated influenza vaccine is associated with cost savings and better outcomes compared to standard-dose inactivated influenza vaccine in Canadian seniors.
Seasonal influenza infects approximately 10-20% of Canadians each year, causing an estimated 12,200 hospitalizations and 3,500 deaths annually, mostly occurring in adults ≥65 years old (seniors). A 32,000-participant, randomized controlled clinical trial (FIM12; Clinicaltrials.gov NCT01427309) showed that high-dose inactivated influenza vaccine (IIV-HD) is superior to standard-dose vaccine (SD) in preventing laboratory-confirmed influenza illness in seniors. In this study, we performed a cost-utility analysis (CUA) of IIV-HD versus SD in FIM12 participants from a Canadian perspective. Healthcare resource utilization data collected in FIM12 included: medications, non-routine/urgent care and emergency room visits, and hospitalizations. Unit costs were applied using standard Canadian cost sources to estimate the mean direct medical and societal costs associated with each vaccine (2014 CAD). Clinical illness data from the trial were mapped to quality-of-life data from the literature to estimate differences in effectiveness between vaccines. Time horizon was one influenza season, however, quality-adjusted life-years (QALYs) lost due to death during the study were captured over a lifetime. A probabilistic sensitivity analysis (PSA) was also performed. Average per-participant medical costs were $47 lower and societal costs $60 lower in the IIV-HD arm. Hospitalizations contributed 91% of the total cost and were less frequent in the IIV-HD arm. IIV-HD provided a gain in QALYs and, due to cost savings, dominated SD in the CUA. The PSA indicated that IIV-HD is 89% likely to be cost saving. In Canada, IIV-HD is expected to be a less costly and more effective alternative to SD, driven by a reduction in hospitalizations.
a Optum , Burlington, Ontario , Canada.
Debbie L
DL
Becker
b Sanofi Pasteur , Swiftwater , PA , USA.|c Leslie Dan School of Pharmacy , University of Toronto , Ontario , Canada.
Ayman
A
Chit
b Sanofi Pasteur , Swiftwater , PA , USA.
Carlos A
CA
DiazGranados
a Optum , Burlington, Ontario , Canada.
Michael
M
Maschio
d inVentiv Health Clinical , Burlington, Ontario , Canada.
Eddy
E
Yau
e Centre for Health Economics , University of York , Heslington, York , UK.
Michael
M
Drummond
D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D011788:Quality of Life; D016896:Treatment Outcome; D015164:Vaccines, Inactivated / Q000008:administration & dosage / Q000276:immunology
D007252:Influenza Vaccines; D015164:Vaccines, Inactivated
Fluzone; cost-effectiveness; cost-utility; high-dose inactivated influenza vaccine; influenza
Stat Med. 2003 Jun 30;22(12):1955-76
12802815
Vaccine. 2015 Sep 11;33(38):4988-93
26212007
Lancet Infect Dis. 2015 Dec;15(12):1459-66
26362172
Health Econ. 2001 Dec;10(8):779-87
11747057
MMWR Morb Mortal Wkly Rep. 2010 Aug 27;59(33):1057-62
20798667
MMWR Morb Mortal Wkly Rep. 2012 Jun 8;61(22):414-20
22672977
Vaccine. 2007 Jun 28;25(27):5086-96
17544181
MMWR Morb Mortal Wkly Rep. 2013 Dec 13;62(49):997-1000
24336131
Vaccine. 2015 Jan 29;33(5):734-41
25444791
MMWR Morb Mortal Wkly Rep. 2013 Jun 14;62(23):473-9
23760189
N Engl J Med. 2014 Aug 14;371(7):635-45
25119609
Epidemiol Infect. 2007 Oct;135(7):1109-16
17306052