Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep 8;15(1):166.
doi: 10.1186/s12916-017-0932-3.

Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England

Dominic Thorrington  1 , Edwin van Leeuwen  2   3 , Mary Ramsay  4 , Richard Pebody  2 , Marc Baguelin  2   5
Affiliations

Cost-effectiveness analysis of quadrivalent seasonal influenza vaccines in England

Dominic Thorrington et al. BMC Med. .

Abstract

Background: As part of the national seasonal influenza vaccination programme in England and Wales, children receive a quadrivalent vaccine offering protection against two influenza A strains and two influenza B strains. Healthy children receive a quadrivalent live attenuated influenza vaccine (QLAIV), whilst children with contraindications receive the quadrivalent inactivated influenza vaccine (QIIV). Individuals aged younger than 65 years in the clinical risk populations and elderly individuals aged 65+ years receive either a trivalent inactivated influenza vaccine (TIIV) offering protection from two A strains and one B strain or the QIIV at the choice of their general practitioner. The cost-effectiveness of quadrivalent vaccine programmes is an open question. The original analysis that supported the paediatric programme only considered a trivalent live attenuated vaccine (LAIV). The cost-effectiveness of the QIIV to other patients has not been established. We sought to estimate the cost-effectiveness of these programmes, establishing a maximum incremental total cost per dose of quadrivalent vaccines over trivalent vaccines.

Methods: We used the same mathematical model as the analysis that recommended the introduction of the paediatric influenza vaccination programme. The incremental cost of the quadrivalent vaccine is the additional cost over that of the existing trivalent vaccine currently in use.

Results: Introducing quadrivalent vaccines can be cost-effective for all targeted groups. However, the cost-effectiveness of the programme is dependent on the choice of target cohort and the cost of the vaccines: the paediatric programme is cost-effective with an increased cost of £6.36 per dose, though an extension to clinical risk individuals younger than 65 years old and further to all elderly individuals means the maximum incremental cost is £1.84 and £0.20 per dose respectively.

Conclusions: Quadrivalent influenza vaccines will bring substantial health benefits, as they are cost-effective in particular target groups.

Keywords: Cost-effectiveness; Influenza; LAIV; QALY; Quadrivalent vaccines; Vaccination.

PubMed Disclaimer

Conflict of interest statement

Competing interests

The authors declare that they have no competing interests.

Consent for publication

Not applicable.

Ethics approval and consent to participate

Not applicable.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Scenarios simulated in the model
Fig. 2
Fig. 2
Distribution of the number of infections for each vaccination scenario
Fig. 3
Fig. 3
Tornado plot showing the estimated change in the maximum incremental cost per dose of the quadrivalent vaccines for programme 1, assuming a WTP threshold of £20,000 per QALY
See this image and copyright information in PMC

References

    1. Cromer D, van Hoek AJ, Jit M, Edmunds WJ, Fleming D, Miller E. The burden of influenza in England by age and clinical risk group: A statistical analysis to inform vaccine policy. J Infect. 2014;68:363–71. doi: 10.1016/j.jinf.2013.11.013. - DOI - PubMed
    1. Glezen WP, Schmier JK, Kuehn CM, Ryan KJ, Oxford J. The burden of influenza B: a structured literature review. Am J Public Health. 2013;103:e43–51. doi: 10.2105/AJPH.2012.301137. - DOI - PMC - PubMed
    1. Baguelin M, Camacho A, Flasche S, Edmunds WJ. Extending the elderly- and risk-group programme of vaccination against seasonal influenza in England and Wales: a cost-effectiveness study. BMC Med. 2015;13:236. doi: 10.1186/s12916-015-0452-y. - DOI - PMC - PubMed
    1. Public Health England. The national flu immunisation programme 2016/17. 2016. https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil.... Accessed 13 Oct 2016.
    1. Pebody R, Warburton F, Andrews N, Ellis J, Von Wissmann B, Robertson C, et al. Effectiveness of seasonal influenza vaccine in preventing laboratory-confirmed influenza in primary care in the United Kingdom: 2014/15 end of season results. Eurosurveillance. 2015;20. doi:10.2807/1560-7917.ES.2015.20.36.30013 - PubMed

MeSH terms