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Stein A, Pendrey C, Muscatello D, Van Buynder P, Fielding J, Menche J, Sullivan S. Estimates of Seasonal Influenza Burden That Could Be Averted by Improved Influenza Vaccines in the Australian Population Aged Under 65 Years, 2015-2019. Influenza Other Respir Viruses 2024; 18:e13289. [PMID: 38637994 PMCID: PMC11026859 DOI: 10.1111/irv.13289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The interpretation of relative vaccine effectiveness (rVE) of improved influenza vaccines is complex. Estimation of burden averted is useful to contextualise their potential impact across different seasons. For the population aged under 65 years in Australia, this study estimated the additional morbidity and mortality that could be averted using improved influenza vaccines. METHODS We used observed, season-specific (2015-2019) influenza notification and influenza-coded hospitalisation frequencies and published modelled estimates of influenza-associated hospitalisations and deaths that occurred under the prevailing influenza vaccination coverage scenario. After back-calculating to the estimated burden in the population without vaccination, we applied published standard influenza vaccine effectiveness and coverage estimates to calculate the burden potentially averted by standard and improved influenza vaccines. A plausible range of rVE values were used, assuming 50% coverage. RESULTS The percentage point difference in absolute vaccine effectiveness (VE) of an improved vaccine compared to a standard vaccine is directly proportional to its rVE and inversely proportional to the effectiveness of the standard vaccine. The incremental burden averted by an improved vaccine is a function of both its difference in absolute VE and the severity of the influenza season. Assuming an rVE of 15% with 50% coverage, the improved vaccine was estimated to additionally avert 1517 to 12,641 influenza notifications, 287 to 1311 influenza-coded hospitalisations and 9 to 33 modelled all-cause influenza deaths per year compared to the standard vaccine. CONCLUSIONS Improved vaccines can have substantial clinical and population impact, particularly when the effectiveness of standard vaccines is low, and burden is high.
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Affiliation(s)
| | - Catherine G. A. Pendrey
- WHO Collaborating Centre for Reference and Research on InfluenzaRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraAustralia
| | | | | | - James E. Fielding
- Victorian Infectious Diseases Reference Laboratoryat the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
| | | | - Sheena G. Sullivan
- WHO Collaborating Centre for Reference and Research on InfluenzaRoyal Melbourne Hospital, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Department of Infectious DiseasesUniversity of Melbourne, at the Peter Doherty Institute for Infection and ImmunityMelbourneAustralia
- Department of EpidemiologyUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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Quist SW, van Schoonhoven AV, Bakker SJL, Pochopień M, Postma MJ, van Loon JMT, Paulissen JHJ. Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands. Cardiovasc Diabetol 2023; 22:328. [PMID: 38017448 PMCID: PMC10685667 DOI: 10.1186/s12933-023-02053-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/04/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND In the Netherlands, more than one million patients have type 2 diabetes (T2D), and approximately 36% of these patients have chronic kidney disease (CKD). Yearly medical costs related to T2D and CKD account for approximately €1.3 billion and €805 million, respectively. The FIDELIO-DKD trial showed that the addition of finerenone to the standard of care (SoC) lowers the risk of CKD progression and cardiovascular (CV) events in patients with CKD stages 2-4 associated with T2D. This study investigates the cost-effectiveness of adding finerenone to the SoC of patients with advanced CKD and T2D compared to SoC monotherapy. METHODS The validated FINE-CKD model is a Markov cohort model which simulates the disease pathway of patients over a lifetime time horizon. The model was adapted to reflect the Dutch societal perspective. The model estimated the incremental costs, utilities, and incremental cost-effectiveness ratio (ICER). Sensitivity and scenario analyses were performed to assess the effect of parameter uncertainty on model robustness. RESULTS When used in conjunction with SoC, finerenone extended time free of CV events and renal replacement therapy by respectively 0.30 and 0.31 life years compared to SoC alone, resulting in an extension of 0.20 quality-adjusted life years (QALYs). The reduction in renal and CV events led to a €6136 decrease in total lifetime costs per patient compared to SoC alone, establishing finerenone as a dominant treatment option. Finerenone in addition to SoC had a 83% probability of being dominant and a 93% probability of being cost-effective at a willingness-to-pay threshold of €20,000. CONCLUSION By reducing the risk of CKD progression and CV events, finerenone saves costs to society while gaining QALYs in patients with T2D and advanced CKD in the Netherlands.
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Affiliation(s)
- Sara W Quist
- Department of Health Sciences, University of Groningen, Groningen, The Netherlands.
- Asc Academics, Groningen, The Netherlands.
| | - Alexander V van Schoonhoven
- Department of Health Sciences, University of Groningen, Groningen, The Netherlands
- Asc Academics, Groningen, The Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Hospital Groningen, Groningen, The Netherlands
| | | | - Maarten J Postma
- Department of Health Sciences, University of Groningen, Groningen, The Netherlands
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
| | | | - Jeroen H J Paulissen
- Department of Health Sciences, University of Groningen, Groningen, The Netherlands
- Asc Academics, Groningen, The Netherlands
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Wang Q, Jin H, Yang L, Jin H, Lin L. Cost-effectiveness of seasonal influenza vaccination of children in China: a modeling analysis. Infect Dis Poverty 2023; 12:92. [PMID: 37821942 PMCID: PMC10566174 DOI: 10.1186/s40249-023-01144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND China has a high burden of influenza-associated illness among children. We aimed to evaluate the cost-effectiveness of introducing government-funded influenza vaccination to children in China (fully-funded policy) compared with the status quo (self-paid policy). METHODS A decision tree model was developed to calculate the economic and health outcomes, from a societal perspective, using national- and provincial-level data. The incremental cost-effectiveness ratio (ICER) [incremental costs per quality-adjusted life year (QALY) gained] was used to compare the fully-funded policy with the self-paid policy under the willingness-to-pay threshold equivalent to national and provincial GDP per capita. Sensitivity analyses were performed and various scenarios were explored based on real-world conditions, including incorporating indirect effect into the analysis. RESULTS Compared to the self-paid policy, implementation of a fully-funded policy could prevent 1,444,768 [95% uncertainty range (UR): 1,203,446-1,719,761] symptomatic cases, 92,110 (95% UR: 66,953-122,226) influenza-related hospitalizations, and 6494 (95% UR: 4590-8962) influenza-related death per season. The fully-funded policy was cost-effective nationally (7964 USD per QALY gained) and provincially for 13 of 31 provincial-level administrative divisions (PLADs). The probability of a funded vaccination policy being cost-effective was 56.5% nationally, and the probability in 9 of 31 PLADs was above 75%. The result was most sensitive to the symptomatic influenza rate among children under 5 years [ICER ranging from - 25,612 (cost-saving) to 14,532 USD per QALY gained]. The ICER of the fully-funded policy was substantially lower (becoming cost-saving) if the indirect effects of vaccination were considered. CONCLUSIONS Introducing a government-funded influenza policy for children is cost-effective in China nationally and in many PLADs. PLADs with high symptomatic influenza rate and influenza-associated mortality would benefit the most from a government-funded influenza vaccination program.
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Affiliation(s)
- Qiang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7TH, UK
| | - Huajie Jin
- King's Health Economics, Institute of Psychiatry, Psychology and Neuroscience at King's College London, London, SE5 8AF, UK
| | - Liuqing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China
- Centre for Digital Public Health in Emergencies, Institute for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, 210009, China.
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.
| | - Leesa Lin
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7TH, UK
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong, Hong Kong Special Administrative Region, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China
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Gong Y, Yao X, Peng J, Ma Y, Fang Y, Yan K, Jiang M. Cost-Effectiveness and Health Impacts of Different Influenza Vaccination Strategies for Children in China. Am J Prev Med 2023:S0749-3797(23)00035-1. [PMID: 37037733 DOI: 10.1016/j.amepre.2023.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 04/12/2023]
Abstract
INTRODUCTION We aimed to evaluate the economic and health impacts of 3 influenza vaccines available in China, including trivalent inactivated vaccine, quadrivalent inactivated vaccine, and live attenuated influenza vaccine, for children aged 6 months to 18 years. METHODS Two decision-analytic models were developed to simulate 4 vaccination strategies. Outcomes included total costs from a societal perspective in 2021, quality-adjusted life-year loss, numbers of outpatient and inpatient cases, and deaths avoided using each strategy. Deterministic and probabilistic sensitivity analyses were performed to examine the uncertainty of model inputs. RESULTS For children aged 6 months to 3 years, trivalent inactivated vaccine saved $48 million and avoided a loss of 17,637 quality-adjusted life-years compared with no vaccination. For children aged 3-18 years, quadrivalent inactivated vaccine was cost-effective compared with trivalent inactivated vaccine, with an incremental cost-effectiveness ratio of $32,948.5/quality-adjusted life-year (willingness-to-pay threshold=$37,653/quality-adjusted life-year), which was sensitive to the RR of vaccine effectiveness of quadrivalent inactivated vaccine versus of trivalent inactivated vaccine. When compared with quadrivalent inactivated vaccine, live attenuated influenza vaccine was $1.28 billion more costly but gained an additional 13,560 quality-adjusted life-years; its incremental cost-effectiveness ratio was $123,983.8/quality-adjusted life-year. Live attenuated influenza vaccine would be cost-effective if its vaccine effectiveness was >0.79. Probabilistic sensitivity analysis revealed that quadrivalent inactivated vaccine, trivalent inactivated vaccine, live attenuated influenza vaccine, and no vaccination were cost-effective in 55.94%, 33.09%, 10.97%, and 0% of 10,000 Monte Carlo simulations. CONCLUSIONS Trivalent inactivated vaccine was cost-effective compared with no vaccination in children aged 6 months to 18 years. Of the 3 vaccination strategies for children aged 3-18 months, quadrivalent inactivated vaccine appears to be the most cost-effective.
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Affiliation(s)
- Yilin Gong
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Department of Pharmacy, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, China
| | - Xuelin Yao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Jin Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Yue Ma
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China
| | - Kangkang Yan
- Department of Pharmacy, Xi'an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, China
| | - Minghuan Jiang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, China; Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China; Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China; Research Institute for Drug Safety and Monitoring, Institute of Pharmaceutical Science and Technology, Western China Science & Technology Innovation Harbor, Xi'an, China.
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Villani L, D'Ambrosio F, Ricciardi R, Waure C, Calabrò GE. Seasonal influenza in children: Costs for the health system and society in Europe. Influenza Other Respir Viruses 2022; 16:820-831. [PMID: 35429133 PMCID: PMC9343336 DOI: 10.1111/irv.12991] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/29/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Leonardo Villani
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Floriana D'Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation) Spin‐Off of Università Cattolica del Sacro Cuore Rome Italy
| | - Chiara Waure
- Department of Medicine and Surgery University of Perugia Perugia Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation) Spin‐Off of Università Cattolica del Sacro Cuore Rome Italy
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Boersma C, Postma MJ. Health Economics of Vaccines: From Current Practice to Future Perspectives. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1-2. [PMID: 33431140 PMCID: PMC7733792 DOI: 10.1016/j.jval.2020.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 05/05/2023]
Affiliation(s)
- Cornelis Boersma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Management Sciences, Open University The Netherlands, Heerlen, The Netherlands; Health-Ecore Ltd, Zeist, The Netherlands
| | - Maarten J Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, The Netherlands; Health-Ecore Ltd, Zeist, The Netherlands; Department of Pharmacy, University of Groningen, Groningen, The Netherlands; Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands; Department of Pharmacology and Therapy, Universitas Airlangga, Surabaya, Indonesia; Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia.
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