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Cost-effectiveness of influenza vaccine strategies for the elderly in South Korea

Author

Listed:
  • Jae-Won Yun
  • Min Joo Choi
  • Gyeong-Seon Shin
  • Jae-Ok Lim
  • Ji Yun Noh
  • Yun-Kyung Kim
  • Joon Young Song
  • Woo Joo Kim
  • Sang-Eun Choi
  • Hee Jin Cheong

Abstract

Objectives: Despite a high vaccine uptake rate of over 80% in South Korea, the disease burden of influenza is still high among the elderly, which may be due to low effectiveness of vaccines. Therefore, the cost-effectiveness of use among the elderly was analyzed in order to compare the current trivalent influenza vaccine (TIV) with a quadrivalent influenza vaccine (QIV) or MF59-adjuvanted trivalent influenza vaccine (ATIV). Methods: A static lifetime Markov model was used. It was assumed that the model would be repeated until individuals reached the age of 100. Cost-effectiveness was analyzed across three age groups (65–74 years, 75–84 years, and ≥85 years), and the at-risk group was studied. Results: Compared to the TIV, the QIV was expected to reduce the number of influenza infections by 342,873, complications by 17,011, hospitalizations by 8,568, and deaths by 2,031. The QIV was highly cost-effective when compared to the TIV, with a base case incremental cost-effectiveness ratio (ICER) estimated at USD 17,699/QALY (1USD = 1,151KRW), and the ICER decreased with age and was USD 3,431/QALY in the group aged 85 and above. Sensitivity analysis revealed that the ICER was sensitive to the QIV price, the proportion of influenza B, and vaccine mismatching. On the other hand, the ATIV was expected to reduce the number of influenza cases and complications by 1,812,395 and 89,747, respectively, annually, yielding cost-saving among all ages. ATIV price and vaccine efficacy were the most influential parameters for the ICER of ATIV. Conclusions: The QIV and ATIV strategies were considered more cost-effective in comparison to the TIV for vaccination strategies implemented for the elderly. However, owing to a lack of data on the effectiveness of ATIV among the elderly, a large-scale effectiveness study is required.

Suggested Citation

  • Jae-Won Yun & Min Joo Choi & Gyeong-Seon Shin & Jae-Ok Lim & Ji Yun Noh & Yun-Kyung Kim & Joon Young Song & Woo Joo Kim & Sang-Eun Choi & Hee Jin Cheong, 2019. "Cost-effectiveness of influenza vaccine strategies for the elderly in South Korea," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-20, January.
    • Handle: RePEc:plo:pone00:0209643
    DOI: 10.1371/journal.pone.0209643
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    References listed on IDEAS

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    1. Lisa Nagy & Terho Heikkinen & Alfred Sackeyfio & Richard Pitman, 2016. "The Clinical Impact and Cost Effectiveness of Quadrivalent Versus Trivalent Influenza Vaccination in Finland," PharmacoEconomics, Springer, vol. 34(9), pages 939-951, September.
    2. David N Fisman & Ashleigh R Tuite, 2011. "Estimation of the Health Impact and Cost-Effectiveness of Influenza Vaccination with Enhanced Effectiveness in Canada," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-9, November.
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