Abstract
Background
The high-dose quadrivalent formulation (QIV-HD) has shown improved protection against influenza and its complications in older adults. We aimed to evaluate the cost-effectiveness of QIV-HD compared with QIV-SD among Korean adults aged ≥ 65 years in reducing influenza-related disease burden.
Methods
We evaluated the 2016/2017 and 2017/2018 seasons and their average values using a static decision tree model. For the main analysis, hospitalization was defined as cardiorespiratory disease-related. The difference in efficacy between standard-dose (SD) and high-dose (HD) was calculated based on the results of a clinical trial comparing Fluzone® High-Dose Vaccine and Fluzone® Vaccine in older adults. Incremental cost-effectiveness ratios (ICERs) were assessed from the healthcare system perspective. A discount rate of 4.5% was applied to life-year-gained (LYG) values and utilities. We performed deterministic and probabilistic sensitivity analyses to account for both epidemiological and economic sources of uncertainty.
Results
In the analysis of the 2017/2018 season, the QIV-HD strategy generated an excess of 0.003953 quality-adjusted life-years (QALYs) compared with QIV-SD. The ICER was 6,467.56 USD/QALY. For the 2016/2017 season, QIV-HD caused an excess of 0.003272 QALYs and ICER was 7,902.46 USD /QALY. From the average data of the two seasons, an excess of 0.003561 QALYs were generated and the ICER was 7,190.44 USD/QALY. In the one-way sensitivity analysis, the parameters with the greatest impact on the results were the relative VE of QIV-HD vs. QIV-SD against influenza-associated hospitalization. PSAs were conducted for the 2016/2017 and 2017/2018 seasons, with the cost of the QIV-HD vaccine fixed at 50,000 KRW (40.48 USD) or 65,000 KRW (52.62 USD). The results showed that for a WTP threshold of 24,692.36 USD/QALY, the probability that QIV-HD is a cost-effective option for the Korean health system is 100% in all seasons and QIV-HD vaccine costs considered.
Conclusion
From the healthcare system perspective, QIV-HD was a more cost-effective vaccination option in reducing influenza-related disease burden and healthcare costs in Koreans aged ≥ 65 years compared with QIV-SD.
Disclosures
Hee Jin Cheong, M.D., Ph.D., Sequiris: Advisor/Consultant Jung-Min Lee, n/a, Sanofi Korea: Stocks/Bonds