Public health and economic impact of seasonal influenza vaccination with quadrivalent influenza vaccines compared to trivalent influenza vaccines in Europe

Abstract

Influenza B strains represent on average 23% of all circulating strains in Europe and when there is a vaccine mismatch on B strains, additional influenza-related hospitalizations and deaths as well as substantial additional costs are observed. The objective was to estimate the public health and economic impact of seasonal influenza vaccination with quadrivalent influenza vaccines (QIV) compared to trivalent influenza vaccines (TIV) in Europe (EU). Based on data from 5 EU countries (France, Germany, Italy, Spain and UK) during 10 influenza seasons from 2002 to 2013, epidemiological and associated economic outcomes were estimated for each season for the actual scenario where the TIV was used, and for a hypothetical scenario where QIV could have been used instead. By using QIV, this study estimated that for the 5 EU countries, an additional 1.03 million (327.9/100,000 inhabitants) influenza cases, 453,000 (143.9/100,000) general practitioners consultations, 672,000 (213.1/100,000) workdays lost, 24,000 (7.7/100,000) hospitalizations and 10,000 (3.1/100,000) deaths could have been avoided compared to the use of TIV over the 10-seasons-period. This study estimates that QIV can be of economic value since from a societal perspective 15 million Euros would have been saved on general practitioners consultations (14 million Euros from third-party payer perspective), 77 million on hospitalizations (74 million Euros from third-party payer perspective) and 150 million Euros on workdays lost, across the 5 EU countries. In conclusion, the present study estimates that, compared to TIV, QIV may result in a substantial decrease in epidemiological burden and in influenza-related costs.

Keywords: Europe; epidemiology; immunization programs; influenza vaccines; public health.

Figure 1.

Influenza cases avoided per season for the 5 EU countries if QIV vaccine was used instead of a TIV vaccine during the 2002–03 to 2012–13 influenza seasons.

Figure 2.

Total costs avoided if QIV vaccine was used instead of a TIV vaccine according to TPP and SP perspectives for the 5 EU countries for the 2002–03 to 2012–13 influenza seasons.

Figure 3.

Deterministic sensitivity analysis represented by tornado charts reports the impact of the parameters on the number of influenza cases per season in EU-5.

Figure 4.

Deterministic sensitivity analysis represented by tornado charts reports the effect of varying various parameters on the average cost savings per season according to TPP and SP for the 5 EU countries during the 2002–03 to 2012–13 influenza seasons.