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Cost effectiveness of trivalent and quadrivalent influenza vaccines in 50- to 64-year-old adults in Korea
Institution:1. Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea;2. Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, Republic of Korea
Abstract:BackgroundInfluenza causes severe complications in at-risk populations, resulting in significant morbidity and mortality. Vaccination is the most effective measure to prevent infection and complications caused by seasonal influenza. However, no study has analyzed the cost-effectiveness of influenza vaccines in 50- to 64-year-olds in South Korea.ObjectiveWe examined the application of the National Immunization Program (NIP) in 50- to 64-year-olds and compared the cost-effectiveness of quadrivalent influenza vaccine (QIV) with that of trivalent influenza vaccine (TIV) in South Korea.MethodsOne-year static model was assumed by constructing separate decision trees for age subgroups: 50–54, 55–59, and 60–64. Each subgroup was divided into at-risk and not-at-risk groups. Using circulation data from previous studies and Korea Centers for Disease Control and Prevention, we estimated the probabilities of influenza infection, outpatient treatment, hospitalization, and deaths. Medical cost was estimated from 2015 to 2017 National Health Insurance Sharing Service claim data, while productivity losses from work absenteeism or death were estimated from labor and economic surveys of Korean government. Disutility was estimated based on previous studies.ResultsCompared with non-vaccination, incremental cost-effectiveness ratios (ICERs) for the 50–54, 55–59, and 60–64 age groups for TIV were US$2010.90, US$2004.58, and US$1865.55, respectively, while for QIV were US$2187.17, US$2190.89, and US$2074.52, respectively. Compared with TIV, ICERs for QIV were US$4445.66, US$4578.06, and US$4751.93, respectively. All the aforementioned ICER values were lower than the 2017 Korean GDP per capita of US$29,742.839.ConclusionImplementing the NIP in the 50- to 64-year-old age group was found to be cost effective. Since both TIV and QIV were cost effective, we recommend QIV as the preferred option, based on its greater protection against Influenza B.
Keywords:Seasonal influenza  Vaccination  Trivalent  Quadrivalent  Cost-effectiveness  South Korea  VE"}  {"#name":"keyword"  "$":{"id":"k0040"}  "$$":[{"#name":"text"  "_":"Vaccine efficacy  NHISS"}  {"#name":"keyword"  "$":{"id":"k0050"}  "$$":[{"#name":"text"  "_":"National Health Insurance Sharing Service  U"}  {"#name":"keyword"  "$":{"id":"k0060"}  "$$":[{"#name":"text"  "_":"Utility  MM"}  {"#name":"keyword"  "$":{"id":"k0070"}  "$$":[{"#name":"text"  "_":"Mismatch rate  VM"}  {"#name":"keyword"  "$":{"id":"k0080"}  "$$":[{"#name":"text"  "_":"Vaccine efficacy when matched VMM  when mismatched  IR"}  {"#name":"keyword"  "$":{"id":"k0090"}  "$$":[{"#name":"text"  "_":"Infection rate  MA"}  {"#name":"keyword"  "$":{"id":"k0100"}  "$$":[{"#name":"text"  "_":"Medical attendance
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