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. 2020 Aug;18(4):519-531.
doi: 10.1007/s40258-019-00534-y.

Constrained Optimization for the Selection of Influenza Vaccines to Maximize the Population Benefit: A Demonstration Project

Baudouin Standaert  1 , Ilse Van Vlaenderen  2 , Laure-Anne Van Bellinghen  2 , Sandra Talbird  3 , Katherine Hicks  3 , Justin Carrico  3 , Philip O Buck  4
Affiliations

Constrained Optimization for the Selection of Influenza Vaccines to Maximize the Population Benefit: A Demonstration Project

Baudouin Standaert et al. Appl Health Econ Health Policy. 2020 Aug.

Abstract

Background: Influenza is an infectious disease causing a high annual economic and public health burden. The most efficient management of the disease is through prevention with vaccination. Many influenza vaccines are available, with varying efficacy and cost, targeting different age groups. Therefore, strategic decision-making about which vaccine to deliver to whom is warranted to improve efficiency.

Objective: We present the use of a constrained optimization (CO) model to evaluate targeted strategies for providing influenza vaccines in three adult age groups in the USA.

Methods: CO was considered for identifying an influenza vaccine provision strategy that maximizes the benefits at constrained annual budgets, by prioritizing vaccines based on return on investment. The approach optimizes a set of predefined outcome measures over several years resulting from an increasing investment using the best combination of influenza vaccines.

Results: Results indicate the importance of understanding the relative differences in benefits for each vaccine type within and across age groups. Scenario and threshold analyses demonstrate the impact of changing budget distribution over time, price setting per vaccine type, and selection of outcome measure to optimize.

Conclusion: Significant gains in cost efficiency can be realized for a decision maker using a CO model, especially for a disease like influenza with many vaccine options. Testing the model under different scenarios offers powerful insights into maximum achievable benefit overall and per age group within the predefined constraints of a vaccine budget.

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Conflict of interest statement

B. Standaert and P. Buck are employees of the GSK group of companies and declare restricted shares ownership in the GSK group of companies. I. Van Vlaenderen, L.A. Van Bellinghen, S. Talbird, K. Hicks, and J. Carrico declare that their institutions have received fees from the GSK group of companies during the conduct of the study reported here as well as for projects outside the submitted work.

Figures

Fig. 1
Fig. 1
Annual vaccination strategy coverage (bars) and QALYs gained (solid red line) resulting from the best allocation of funding to minimize QALY losses from influenza. Adj adjuvanted, Recom recombinant, QIV quadrivalent influenza vaccine, TIV trivalent influenza vaccine, QALY quality-adjusted life year
Fig. 2
Fig. 2
QALY gain difference and disease management cost-offset difference between an optimized vaccination strategy versus the worst scenario of unoptimized condition, with the same total budget allocation over time as described in Fig. 1. Diff difference in outcome between strategies: optimized versus random allocation, QALY quality-adjusted life year
Fig. 3
Fig. 3
Annual vaccination strategy coverage (bars) and associated QALYs gained (red solid line (higher fund) and brown dotted line (lower fund)) resulting from best allocation of the funding at start to minimize QALY losses from influenza with an increased annual vaccination budget compared with base-case. Adj adjuvanted, Recom recombinant, QIV quadrivalent influenza vaccine, TIV trivalent influenza vaccine, QALY quality-adjusted life year, HB high budget, LB lower (base-case) budget
Fig. 4
Fig. 4
Annual vaccination strategy coverage (bars) resulting from the best allocation of TIV with perfect match (equal effectiveness as QIV) in < 65-year-old adults to minimize QALY losses from influenza. Adj adjuvanted, Recom recombinant, QIV quadrivalent influenza vaccine, TIV trivalent influenza vaccine, QALY quality-adjusted life year
Fig. 5
Fig. 5
Annual strategy coverage and QALYs resulting from the best allocation of funding to minimize medical visits for influenza. Adj adjuvanted, Recom recombinant, QIV quadrivalent influenza vaccine, TIV trivalent influenza vaccine
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