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Cost-Effectiveness of Pediatric Influenza Vaccination in The Netherlands.
Value Health. 2021 01; 24(1):19-31.VH

Abstract

OBJECTIVE

This study evaluates the cost-effectiveness of extending the Dutch influenza vaccination program for elderly and medical high-risk groups to include pediatric influenza vaccination, taking indirect protection into account.

METHODS

An age-structured dynamic transmission model was used that was calibrated to influenza-associated GP visits over 4 seasons (2010-2011 to 2013-2014). The clinical and economic impact of different pediatric vaccination strategies were compared over 20 years, varying the targeted age range, the vaccine type for children or elderly and high-risk groups. Outcome measures include averted symptomatic infections and deaths, societal costs and quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Costs and QALYs were discounted at 4% and 1.5% annually.

RESULTS

At an assumed coverage of 50%, adding pediatric vaccination for 2- to 17-year-olds with quadrivalent live-attenuated vaccine to the current vaccination program for elderly and medical high-groups with quadrivalent inactivated vaccine was estimated to avert, on average, 401 820 symptomatic cases and 72 deaths per year. Approximately half of averted symptomatic cases and 99% of averted deaths were prevented in other age groups than 2- to 17-year-olds due to herd immunity. The cumulative discounted 20-year economic impact was 35 068 QALYs gained and €1687 million saved, that is, the intervention was cost-saving. This vaccination strategy had the highest probability of being the most cost-effective strategy considered, dominating pediatric strategies targeting 2- to 6-year-olds or 2- to 12-year-olds or strategies with trivalent inactivated vaccine.

CONCLUSION

Modeling indicates that introducing pediatric influenza vaccination in The Netherlands is cost-saving, reducing the influenza-related disease burden substantially.

Authors+Show Affiliations

Unit of PharmacoTherapy, -Epidemiology, and -Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands. Electronic address: ptdeboer85@gmail.com.Unit of PharmacoTherapy, -Epidemiology, and -Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands.ICON Health Economics and Epidemiology, Oxfordshire, United Kingdom.Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.ICON Health Economics and Epidemiology, Oxfordshire, United Kingdom.Unit of PharmacoTherapy, -Epidemiology, and -Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands; Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands; Department of Economics, Econometrics, and Finance, Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33431149

Citation

de Boer, Pieter T., et al. "Cost-Effectiveness of Pediatric Influenza Vaccination in the Netherlands." Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research, vol. 24, no. 1, 2021, pp. 19-31.
de Boer PT, Nagy L, Dolk FCK, et al. Cost-Effectiveness of Pediatric Influenza Vaccination in The Netherlands. Value Health. 2021;24(1):19-31.
de Boer, P. T., Nagy, L., Dolk, F. C. K., Wilschut, J. C., Pitman, R., & Postma, M. J. (2021). Cost-Effectiveness of Pediatric Influenza Vaccination in The Netherlands. Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research, 24(1), 19-31. https://doi.org/10.1016/j.jval.2020.10.011
de Boer PT, et al. Cost-Effectiveness of Pediatric Influenza Vaccination in the Netherlands. Value Health. 2021;24(1):19-31. PubMed PMID: 33431149.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-Effectiveness of Pediatric Influenza Vaccination in The Netherlands. AU - de Boer,Pieter T, AU - Nagy,Lisa, AU - Dolk,Franklin C K, AU - Wilschut,Jan C, AU - Pitman,Richard, AU - Postma,Maarten J, Y1 - 2020/12/11/ PY - 2019/12/31/received PY - 2020/10/05/revised PY - 2020/10/07/accepted PY - 2021/1/12/entrez PY - 2021/1/13/pubmed PY - 2021/1/13/medline KW - children KW - cost-effectiveness KW - dynamic transmission model KW - economic evaluation KW - influenza KW - vaccination SP - 19 EP - 31 JF - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research JO - Value Health VL - 24 IS - 1 N2 - OBJECTIVE: This study evaluates the cost-effectiveness of extending the Dutch influenza vaccination program for elderly and medical high-risk groups to include pediatric influenza vaccination, taking indirect protection into account. METHODS: An age-structured dynamic transmission model was used that was calibrated to influenza-associated GP visits over 4 seasons (2010-2011 to 2013-2014). The clinical and economic impact of different pediatric vaccination strategies were compared over 20 years, varying the targeted age range, the vaccine type for children or elderly and high-risk groups. Outcome measures include averted symptomatic infections and deaths, societal costs and quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Costs and QALYs were discounted at 4% and 1.5% annually. RESULTS: At an assumed coverage of 50%, adding pediatric vaccination for 2- to 17-year-olds with quadrivalent live-attenuated vaccine to the current vaccination program for elderly and medical high-groups with quadrivalent inactivated vaccine was estimated to avert, on average, 401 820 symptomatic cases and 72 deaths per year. Approximately half of averted symptomatic cases and 99% of averted deaths were prevented in other age groups than 2- to 17-year-olds due to herd immunity. The cumulative discounted 20-year economic impact was 35 068 QALYs gained and €1687 million saved, that is, the intervention was cost-saving. This vaccination strategy had the highest probability of being the most cost-effective strategy considered, dominating pediatric strategies targeting 2- to 6-year-olds or 2- to 12-year-olds or strategies with trivalent inactivated vaccine. CONCLUSION: Modeling indicates that introducing pediatric influenza vaccination in The Netherlands is cost-saving, reducing the influenza-related disease burden substantially. SN - 1524-4733 UR - https://www.unboundmedicine.com/medline/citation/33431149/Cost_Effectiveness_of_Pediatric_Influenza_Vaccination_in_The_Netherlands_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1098-3015(20)34455-7 DB - PRIME DP - Unbound Medicine ER -