背景:在法国,流感占与全科医生的平均咨询次数超过一百万次,两万人住院,每年有9000人死亡,尤其是在65岁以上的人群中。这项研究评估了法国65岁及以上人群的佐剂四价流感疫苗(aQIV)与标准(SD-QIV)和高剂量(HD-QIV)四价流感疫苗的成本效益。
方法:年龄结构化的SEIR传输模型,校准以模拟平均流感季节,结合了一个联系矩阵来估计组间联系率。流行病学,经济,并评估效用结果。疫苗有效性和成本来自文献和国家保险数据。应用流感发作率和住院率的生活质量调整。还进行了确定性和概率分析。
结果:与SD-QIV相比,aQIV表明医疗保健利用率和死亡率大幅下降,避免89,485名GP咨询,2144例住院,防止1611人死亡。尽管投资了1.1亿欧元,aQIV产生净节省1400万欧元的医疗保健支出。与HD-QIV相比,aQIV节省了6200万欧元的疫苗接种费用。成本效益分析显示,每QALY的增量成本效益比为7062欧元。
结论:本研究强调了aQIV与SD-QIV和HD-QIV的成本效益,预防流感病例,住院治疗,和死亡。
BACKGROUND: In
France, influenza accounts for an average of over one million consultations with GPs, 20,000 hospitalizations, and 9000 deaths per year, particularly among the over-65s. This study evaluates the cost-effectiveness of the adjuvanted quadrivalent influenza vaccine (aQIV) compared to standard (SD-QIV) and high-dose (HD-QIV) quadrivalent influenza vaccines for individuals aged 65 and older in
France.
METHODS: The age-structured SEIR transmission model, calibrated to simulate a mean influenza season, incorporates a contact matrix to estimate intergroup contact rates. Epidemiological, economic, and utility outcomes are evaluated. Vaccine effectiveness and costs are derived from literature and national insurance data. Quality of life adjustments for influenza attack rates and hospitalizations are applied. Deterministic and probabilistic analyses are also conducted.
RESULTS: Compared to SD-QIV, aQIV demonstrates substantial reductions in healthcare utilization and mortality, avoiding 89,485 GP consultations, 2144 hospitalizations, and preventing 1611 deaths. Despite an investment of EUR 110 million, aQIV yields a net saving of EUR 14 million in healthcare spending. Compared to HD-QIV, aQIV saves 62 million euros on vaccination costs. Cost-effectiveness analysis reveals an incremental cost-effectiveness ratio of EUR 7062 per QALY.
CONCLUSIONS: This study highlights the cost-effectiveness of aQIV versus SD-QIV and HD-QIV, preventing influenza cases, hospitalizations, and deaths.