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Cost-Effectiveness of Increasing Influenza Vaccination Coverage in Adults with Type 2 Diabetes in Turkey

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  • Levent Akın
  • Bérengère Macabéo
  • Zafer Caliskan
  • Serdar Altinel
  • Ilhan Satman

Abstract

Objective: In Turkey, the prevalence of diabetes is high but the influenza vaccination coverage rate (VCR) is low (9.1% in 2014), despite vaccination being recommended and reimbursed. This study evaluated the cost-effectiveness of increasing the influenza VCR of adults with type 2 diabetes in Turkey to 20%. Methods: A decision-analytic model was adapted to Turkey using data derived from published sources. Direct medical costs and indirect costs due to productivity loss were included in the societal perspective. The time horizon was set at 1 year to reflect the seasonality of influenza. Results: Increasing the VCR for adults with type 2 diabetes to 20% is predicted to avert an additional 19,777 influenza cases, 2376 hospitalizations, and 236 deaths. Associated influenza costs avoided were estimated at more than 8.3 million Turkish Lira (TRY), while the cost of vaccination would be more than TRY 8.4 million. The incremental cost-effectiveness ratio was estimated at TRY 64/quality-adjusted life years, which is below the per capita gross domestic product of TRY 21,511 and therefore very cost-effective according to World Health Organization guidelines. Factors most influencing the incremental cost-effectiveness ratio were the excess hospitalization rate, inpatient cost, vaccine effectiveness against hospitalization, and influenza attack rate. Increasing the VCR to >20% was also estimated to be very cost-effective. Conclusions: Increasing the VCR for adults with type 2 diabetes in Turkey to ≥20% would be very cost-effective.

Suggested Citation

  • Levent Akın & Bérengère Macabéo & Zafer Caliskan & Serdar Altinel & Ilhan Satman, 2016. "Cost-Effectiveness of Increasing Influenza Vaccination Coverage in Adults with Type 2 Diabetes in Turkey," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.
    • Handle: RePEc:plo:pone00:0157657
    DOI: 10.1371/journal.pone.0157657
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    References listed on IDEAS

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    1. Martin Keech & Paul Beardsworth, 2008. "The Impact of Influenza on Working Days Lost," PharmacoEconomics, Springer, vol. 26(11), pages 911-924, November.
    2. Kaan Sözmen & Belgin Unal & Simon Capewell & Julia Critchley & Martin O’Flaherty, 2015. "Estimating diabetes prevalence in Turkey in 2025 with and without possible interventions to reduce obesity and smoking prevalence, using a modelling approach," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(1), pages 13-21, January.
    3. Bohdan Nosyk & Behnam Sharif & Huiying Sun & Curtis Cooper & Aslam H Anis & on behalf of the CIHR Canadian HIV Trials Network Influenza Vaccine Research Group, 2011. "The Cost-Effectiveness and Value of Information of Three Influenza Vaccination Dosing Strategies for Individuals with Human Immunodeficiency Virus," PLOS ONE, Public Library of Science, vol. 6(12), pages 1-11, December.
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