Table 4.
Summary of economic studies of seasonal influenza vaccination in Canada.
| Citation | Study | Comparison | Findings |
|---|---|---|---|
| Fisman 201169 | Cost-utility analysis conducted using an age-structured compartmental model (dynamic transmission model) | a) MF59-adjuvanted TIV | • Base case showed that MF59-TIV relative to TIV was cost-effective (ICER=CAN$2,111/QALY) in older adults (≥65 years); |
| b) TIV | • The cost of using MF59-TIV was higher than TIV over 10 y (CAN$837.0 million and CAN$730.5 million, respectively) which was offset by reducing the healthcare cost of influenza from CAN$501.76 million with TIV to CAN$473.50 million with MF59-TIV. | ||
| Tarride 201270 | Cost-utility analysis using a decision tree | a) Trivalent LAIV | • The estimated offset per vaccinated child aged 2–17 y for using LAIV versus TIV was CAN$4.20 in direct costs and CAN$35.34 in societal costs. |
| b) TIV | |||
| Sander 200971 | Cost-utility analysis using a model that simulates influenza transmission | a) No vaccination during the A(H1N1)pdm09 pandemic | • Vaccination of 30% of the population of Ontario against pandemic A(H1N1)pdm09 was estimated to cost CAN$118 million, which was estimated to have reduced the influenza cases rate by 50% vs. no vaccination. |
| b) Mass vaccination achieving 30% vaccine coverage during the A(H1N1)pdm09 pandemic | |||
| Sander 201072 | Cost-utility analysis conducted using influenza incidence estimates (pre and post influenza implementation) | a) Ontario's universal influenza immunization program | • Universal vaccination vs target group vaccination estimated to reduce care services cost by 52%, and save CAN$1,134 QALYs per season; |
| b) Previous program targeted to the high-risk population | • Universal vaccination vs target group vaccination ICER=CAN$10,797/QALY gained. | ||
| Skowronski 200673 | Cost-effectiveness analysis conducted using a decision analysis | a) Vaccination of high-risk populations only | • Cost of universal vaccination for infants 6–23 months versus target group vaccination was not cost-saving for the health system or from a societal perspective; In the first year, the cost was CAN$17 per day of illness averted, CAN$230 per physician visit averted, CAN$13,000 per hospitalization averted, CAN$900,000/QALY gained, and CAN$6 million per death averted. |
| b) Vaccination of high-risk populations only plus all infants/toddlers aged 6–23 months | |||
| Asgary 201274 | Contingent valuation | Determined willingness to pay for access to immediate pandemic A(H1N1)pdm09 influenza vaccine | • Households willing to pay CAN$417.35 for immediate A(H1N1)pdm09 vaccination. |
| Mercer 200975 | Cost-analysis | Determined the most important cost drivers and their economic impact on delivering public health funded influenza vaccines within specified budget | • Most significant cost variables for influenza clinics were labor costs and number of vaccines given per nurse per hour. |
Note: ICER, incremental cost-effectiveness ratio; LAIV, intranasal live attenuated influenza vaccine, trivalent; QALY, quality-adjusted life year; QIV, quadrivalent inactivated influenza vaccine; TIV, trivalent inactivated influenza vaccine.