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...

Full description

Saved in:
Bibliographic Details
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
Subjects:
Online Access:https://www.mdpi.com/2076-393X/13/3/323
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849340272873308160
author Alberto Perez-Rubio
Roberto Flores
Jesus Ruiz Aragon
Javier Sanchez
Sergio Marquez-Peláez
Piedad Alvarez
Andres Osorio Muriel
Joaquin Mould-Quevedo
author_facet Alberto Perez-Rubio
Roberto Flores
Jesus Ruiz Aragon
Javier Sanchez
Sergio Marquez-Peláez
Piedad Alvarez
Andres Osorio Muriel
Joaquin Mould-Quevedo
author_sort Alberto Perez-Rubio
collection DOAJ
description 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.
format Article
id doaj-art-cef0c51a8df64ca8851453bcd0cfa80b
institution Kabale University
issn 2076-393X
language English
publishDate 2025-03-01
publisher MDPI AG
record_format Article
series Vaccines
spelling doaj-art-cef0c51a8df64ca8851453bcd0cfa80b2025-08-20T03:43:57ZengMDPI AGVaccines2076-393X2025-03-0113332310.3390/vaccines13030323Cost-Effectiveness of Adjuvanted Influenza Vaccine Compared with Standard and High-Dose Influenza Vaccines for Persons Aged ≥50 Years in SpainAlberto Perez-Rubio0Roberto Flores1Jesus Ruiz Aragon2Javier Sanchez3Sergio Marquez-Peláez4Piedad Alvarez5Andres Osorio Muriel6Joaquin Mould-Quevedo7Hospital Clínico Universitario de Valladolid, 47003 Valladolid, SpainMedical Scientific Liaison, CSL Seqirus, 08027 Barcelona, SpainHospital Universitario Puerta del Mar, 11009 Cádiz, SpainModeling and Simulation, Evidera, Torre Nozar, Titan, 15, 28045 Madrid, SpainDepartment of Economics, Economic Analysis, Faculty of Business Pablo de Olavide University, 41013 Seville, SpainEvidence, Modeling, and Synthesis, Evidera, 500 Totten Pond Road, Waltham, MA 02451, USAModeling and Simulation, Evidera, Bogota CO Calle 90, Bogota 110221, ColombiaGlobal Health Economics, CSL Seqirus, Summit, NJ 07901, USABackground: 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.https://www.mdpi.com/2076-393X/13/3/323influenzavaccinationSpaincost-effectivenessadjuvantedhigh-dose
spellingShingle Alberto Perez-Rubio
Roberto Flores
Jesus Ruiz Aragon
Javier Sanchez
Sergio Marquez-Peláez
Piedad Alvarez
Andres Osorio Muriel
Joaquin Mould-Quevedo
Cost-Effectiveness of Adjuvanted Influenza Vaccine Compared with Standard and High-Dose Influenza Vaccines for Persons Aged ≥50 Years in Spain
Vaccines
influenza
vaccination
Spain
cost-effectiveness
adjuvanted
high-dose
title Cost-Effectiveness of Adjuvanted Influenza Vaccine Compared with Standard and High-Dose Influenza Vaccines for Persons Aged ≥50 Years in Spain
title_full Cost-Effectiveness of Adjuvanted Influenza Vaccine Compared with Standard and High-Dose Influenza Vaccines for Persons Aged ≥50 Years in Spain
title_fullStr Cost-Effectiveness of Adjuvanted Influenza Vaccine Compared with Standard and High-Dose Influenza Vaccines for Persons Aged ≥50 Years in Spain
title_full_unstemmed Cost-Effectiveness of Adjuvanted Influenza Vaccine Compared with Standard and High-Dose Influenza Vaccines for Persons Aged ≥50 Years in Spain
title_short Cost-Effectiveness of Adjuvanted Influenza Vaccine Compared with Standard and High-Dose Influenza Vaccines for Persons Aged ≥50 Years in Spain
title_sort cost effectiveness of adjuvanted influenza vaccine compared with standard and high dose influenza vaccines for persons aged ≥50 years in spain
topic influenza
vaccination
Spain
cost-effectiveness
adjuvanted
high-dose
url https://www.mdpi.com/2076-393X/13/3/323
work_keys_str_mv AT albertoperezrubio costeffectivenessofadjuvantedinfluenzavaccinecomparedwithstandardandhighdoseinfluenzavaccinesforpersonsaged50yearsinspain
AT robertoflores costeffectivenessofadjuvantedinfluenzavaccinecomparedwithstandardandhighdoseinfluenzavaccinesforpersonsaged50yearsinspain
AT jesusruizaragon costeffectivenessofadjuvantedinfluenzavaccinecomparedwithstandardandhighdoseinfluenzavaccinesforpersonsaged50yearsinspain
AT javiersanchez costeffectivenessofadjuvantedinfluenzavaccinecomparedwithstandardandhighdoseinfluenzavaccinesforpersonsaged50yearsinspain
AT sergiomarquezpelaez costeffectivenessofadjuvantedinfluenzavaccinecomparedwithstandardandhighdoseinfluenzavaccinesforpersonsaged50yearsinspain
AT piedadalvarez costeffectivenessofadjuvantedinfluenzavaccinecomparedwithstandardandhighdoseinfluenzavaccinesforpersonsaged50yearsinspain
AT andresosoriomuriel costeffectivenessofadjuvantedinfluenzavaccinecomparedwithstandardandhighdoseinfluenzavaccinesforpersonsaged50yearsinspain
AT joaquinmouldquevedo costeffectivenessofadjuvantedinfluenzavaccinecomparedwithstandardandhighdoseinfluenzavaccinesforpersonsaged50yearsinspain