Contributions of cost-effectiveness analyses (CEA) to influenza vaccination policy for older adults in Europe |
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Affiliation: | 1. Sciences Po Paris, 27 Rue Saint-Guillaume, 75007 Paris, France;2. EHESP School of Public Health, University of Rennes, CNRS, Arènes - UMR 6051, RSMS – Inserm U 1309, Rennes, France;3. VHN Consulting, Montreal, QC H2V 3L8, Canada;4. Department of Economics, Economic Analysis, Faculty of Business Pablo de Olavide University, 41013 Seville, Spain;5. Department of Health Sciences, University of Groningen, University Medical Center Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands;6. Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, 9713 AV Groningen, The Netherlands;7. Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor 45363, Bandung, Indonesia;8. Department of Mathematics, University of Trento, 38123 Trento, Italy;9. Department of Clinical Microbiology, Lab. Clinical Analysis, Hospital de la Línea, Cádiz, Spain;10. CSL Seqirus Inc., 25 Deforest Avenue, Summit, NJ 07901, USA |
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Abstract: | This review describes the importance of economic evaluations and real-world evidence (RWE) for the assessment of enhanced influenza vaccines for older adults in Europe. Individuals ≥65 years of age are at increased risk of severe influenza outcomes and many countries in Europe recommend enhanced vaccines for this population to mitigate immunosenescence. Some National Immunization Technical Advisory Groups (NITAGs) may preferentially recommend a specific enhanced vaccine, necessitating comparative economic evaluation and estimation of relative vaccine effectiveness between enhanced vaccine options in the absence of direct head-to-head efficacy data. Distinct approaches to economic modeling and cost-effectiveness analysis (CEA) guide national vaccination policies in Europe, including how underlying data, such as RWE, are used in these models. RWE is an important evidence source for input into CEA models based on disease factors (e.g., antigenic shift and seasonal variation) and practical factors (e.g., limitations of performing multiple randomized clinical trials to capture seasonal variation; the need to obtain relevant patient-oriented, real-world endpoints, such as hospitalizations). CEA is considered crucial to vaccine assessment among certain countries in Europe, but further harmonization of economic evaluations, including the use of RWE, across NITAGs in Europe may be of benefit, alongside standardized approaches for vaccine appraisal. In the future, more countries may use RWE as an input in CEA models to support NITAG recommendations for enhanced influenza vaccines in older populations, especially considering the value of RWE for the assessment of influenza epidemiology and vaccine effectiveness as stated by the World Health Organization, and the availability of a broad RWE base for certain enhanced vaccines. |
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Keywords: | Cost-effectiveness analysis Real-world evidence Influenza vaccination Enhanced vaccine aQIV" },{" #name" :" keyword" ," $" :{" id" :" k0030" }," $$" :[{" #name" :" text" ," _" :" adjuvanted quadrivalent influenza vaccine aTIV" },{" #name" :" keyword" ," $" :{" id" :" k0040" }," $$" :[{" #name" :" text" ," _" :" adjuvanted trivalent influenza vaccine CEA" },{" #name" :" keyword" ," $" :{" id" :" k0050" }," $$" :[{" #name" :" text" ," _" :" cost-effectiveness analysis CEESP" },{" #name" :" keyword" ," $" :{" id" :" k0060" }," $$" :[{" #name" :" text" ," _" :" Economic Evaluation and Public Health Commission CEPS" },{" #name" :" keyword" ," $" :{" id" :" k0070" }," $$" :[{" #name" :" text" ," _" :" The Economic Committee for Health Care Products COVID-19" },{" #name" :" keyword" ," $" :{" id" :" k0080" }," $$" :[{" #name" :" text" ," _" :" coronavirus disease 2019 CTV" },{" #name" :" keyword" ," $" :{" id" :" k0090" }," $$" :[{" #name" :" text" ," _" :" Technical Vaccination Commission EU" },{" #name" :" keyword" ," $" :{" id" :" k0100" }," $$" :[{" #name" :" text" ," _" :" European Union HAS" },{" #name" :" keyword" ," $" :{" id" :" k0110" }," $$" :[{" #name" :" text" ," _" :" Haute Autorité de Santé HD-QIV" },{" #name" :" keyword" ," $" :{" id" :" k0120" }," $$" :[{" #name" :" text" ," _" :" high-dose quadrivalent influenza vaccine HD-TIV" },{" #name" :" keyword" ," $" :{" id" :" k0130" }," $$" :[{" #name" :" text" ," _" :" high-dose trivalent influenza vaccine HTA" },{" #name" :" keyword" ," $" :{" id" :" k0140" }," $$" :[{" #name" :" text" ," _" :" health technology assessment JCVI" },{" #name" :" keyword" ," $" :{" id" :" k0150" }," $$" :[{" #name" :" text" ," _" :" Joint Committee on Vaccination and Immunisation NIP" },{" #name" :" keyword" ," $" :{" id" :" k0170" }," $$" :[{" #name" :" text" ," _" :" national immunization program NITAG" },{" #name" :" keyword" ," $" :{" id" :" k0180" }," $$" :[{" #name" :" text" ," _" :" National Immunization Technical Advisory Group QIV" },{" #name" :" keyword" ," $" :{" id" :" k0190" }," $$" :[{" #name" :" text" ," _" :" quadrivalent influenza vaccine QIVr" },{" #name" :" keyword" ," $" :{" id" :" k0200" }," $$" :[{" #name" :" text" ," _" :" recombinant quadrivalent influenza vaccine RCT" },{" #name" :" keyword" ," $" :{" id" :" k0210" }," $$" :[{" #name" :" text" ," _" :" randomized controlled trial rVE" },{" #name" :" keyword" ," $" :{" id" :" k0220" }," $$" :[{" #name" :" text" ," _" :" relative vaccine effectiveness RWE" },{" #name" :" keyword" ," $" :{" id" :" k0230" }," $$" :[{" #name" :" text" ," _" :" real-world evidence TC" },{" #name" :" keyword" ," $" :{" id" :" k0240" }," $$" :[{" #name" :" text" ," _" :" Transparency Commission TIV" },{" #name" :" keyword" ," $" :{" id" :" k0250" }," $$" :[{" #name" :" text" ," _" :" trivalent influenza vaccine UNCAM" },{" #name" :" keyword" ," $" :{" id" :" k0260" }," $$" :[{" #name" :" text" ," _" :" National Union of Health Insurance Funds VE" },{" #name" :" keyword" ," $" :{" id" :" k0270" }," $$" :[{" #name" :" text" ," _" :" vaccine effectiveness WHO" },{" #name" :" keyword" ," $" :{" id" :" k0280" }," $$" :[{" #name" :" text" ," _" :" World Health Organization UK" },{" #name" :" keyword" ," $" :{" id" :" k0160" }," $$" :[{" #name" :" text" ," _" :" United Kingdom |
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