Cost-Effectiveness of Adjuvanted Influenza Vaccine Compared with Standard and High-Dose Influenza Vaccines for Persons Aged ≥50 Years in Spain

Background: The prevalence of chronic conditions that increase the risk of influenza complications is high among individuals aged ≥50 years, and evidence suggests age-related changes in immune responses to vaccines begin to decline at this age. Persons aged 50–59 years have high rates of influenza i...

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Main Authors: Alberto Perez-Rubio, Roberto Flores, Jesus Ruiz Aragon, Javier Sanchez, Sergio Marquez-Peláez, Piedad Alvarez, Andres Osorio Muriel, Joaquin Mould-Quevedo
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Vaccines
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Online Access:https://www.mdpi.com/2076-393X/13/3/323
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Summary:Background: The prevalence of chronic conditions that increase the risk of influenza complications is high among individuals aged ≥50 years, and evidence suggests age-related changes in immune responses to vaccines begin to decline at this age. Persons aged 50–59 years have high rates of influenza infections and are also the most likely age group to be employed. Thus, the burden of influenza is high in this age group. Methods: We investigated the cost-effectiveness of vaccination with an adjuvanted quadrivalent influenza vaccine (aQIV) in a Spanish population aged ≥50 years at high risk of influenza complications. Using a static decision-tree model specifically designed to analyze Spanish data, we calculated incremental cost-effectiveness ratios (ICERs) for aQIV vs. egg-based QIV (QIVe; indicated for any age) and aQIV vs. high-dose QIV (HD-QIV; indicated for persons aged ≥60 years) from payer and societal perspectives. We compared ICERs against a willingness-to-pay threshold of EUR 25,000 per quality-adjusted life year (QALY) gained. The impact of input uncertainty on ICER was evaluated through a probabilistic sensitivity analysis (PSA) and a one-way deterministic sensitivity analysis (DSA). Results: The total incremental cost of vaccination with aQIV was EUR –86,591,967.67, which was associated with gains of 241.02 in QALY (EUR –359,268.05 per QALY gained) and 318.04 in life years (EUR −272,271.37 per life year gain). Compared with the willingness-to-pay threshold of EUR 25,000 per QALY gained, aQIV was the most cost-effective influenza vaccine relative to the combination of QIVe or HD-QIV. These findings were supported by PSA and DSA analyses. Conclusions: In the model, aQIV dominated QIVe and HD-QIV, demonstrating that aQIV use would be cost-saving for persons aged ≥50 years who are at high risk of influenza complications.
ISSN:2076-393X