The Potential Cost-Effectiveness of Quadrivalent versus Trivalent Influenza Vaccine in Elderly People and Clinical Risk Groups in the UK: A Lifetime Multi-Cohort Model
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{"title"=>"The potential cost-effectiveness of quadrivalent versus trivalent influenza vaccine in elderly people and clinical risk groups in the UK: A lifetime multi-cohort model", "type"=>"journal", "authors"=>[{"first_name"=>"Laure Anne", "last_name"=>"Van Bellinghen", "scopus_author_id"=>"55560106000"}, {"first_name"=>"Genevieve", "last_name"=>"Meier", "scopus_author_id"=>"55559152000"}, {"first_name"=>"Ilse", "last_name"=>"Van Vlaenderen", "scopus_author_id"=>"24291924000"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84902576162", "doi"=>"10.1371/journal.pone.0098437", "sgr"=>"84902576162", "isbn"=>"1932-6203", "pmid"=>"24905235", "issn"=>"19326203", "pui"=>"373337381"}, "id"=>"ccae7b7d-19f8-3c8e-b35a-a96a5822b42a", "abstract"=>"OBJECTIVE: To estimate the potential cost-effectiveness of quadrivalent influenza vaccine compared with trivalent influenza vaccine in the UK.\\n\\nMETHODS: A lifetime, multi-cohort, static Markov model was constructed, with nine age groups each divided into healthy and at-risk categories. Influenza A and B were accounted for separately. The model was run in one-year cycles for a lifetime (maximum age: 100 years). The analysis was from the perspective of the UK National Health Service. Costs and benefits were discounted at 3.5%. 2010 UK vaccination policy (vaccination of people at risk and those aged ≥65 years) was applied. Herd effect was not included. Inputs were derived from national databases and published sources where possible. The quadrivalent influenza vaccine price was not available when the study was conducted. It was estimated at £6.72,15% above the trivalent vaccine price of £5.85. Sensitivity analyses used an incremental price of up to 50%.\\n\\nRESULTS: Compared with trivalent influenza vaccine, the quadrivalent influenza vaccine would be expected to reduce the numbers of influenza cases by 1,393,720, medical visits by 439,852 complications by 167,357, hospitalisations for complications by 26,424 and influenza deaths by 16,471. The estimated base case incremental cost-effectiveness ratio (ICER) was £5,299/quality-adjusted life-year (QALY). Sensitivity analyses indicated that the ICER was sensitive to changes in circulation of influenza virus subtypes and vaccine mismatch; all other parameters had little effect. In 96% of simulations the ICER was <£20,000/QALY. Since this analysis was completed, quadrivalent influenza vaccine has become available in the UK at a list price of £9.94. Using this price in the model, the estimated ICER for quadrivalent compared with trivalent vaccination was £27,378/QALY, still within the NICE cost-effectiveness threshold (£20,000-£30,000).\\n\\nCONCLUSIONS: Quadrivalent influenza vaccine could reduce influenza disease burden and would be cost-effective compared with trivalent influenza vaccine in elderly people and clinical risk groups in the UK.", "link"=>"http://www.mendeley.com/research/potential-costeffectiveness-quadrivalent-versus-trivalent-influenza-vaccine-elderly-people-clinical", "reader_count"=>46, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>2, "Researcher"=>13, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>2, "Other"=>4, "Student > Master"=>9, "Student > Bachelor"=>4, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>2, "Researcher"=>13, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>7, "Student > Postgraduate"=>2, "Other"=>4, "Student > Master"=>9, "Student > Bachelor"=>4, "Lecturer"=>1, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Agricultural and Biological Sciences"=>3, "Decision Sciences"=>1, "Economics, Econometrics and Finance"=>3, "Environmental Science"=>1, "Nursing and Health Professions"=>3, "Mathematics"=>1, "Medicine and Dentistry"=>18, "Pharmacology, Toxicology and Pharmaceutical Science"=>4, "Physics and Astronomy"=>1, "Psychology"=>1, "Social Sciences"=>4, "Immunology and Microbiology"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>18}, "Social Sciences"=>{"Social Sciences"=>4}, "Decision Sciences"=>{"Decision Sciences"=>1}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>1}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>4}, "Environmental Science"=>{"Environmental Science"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>4}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>3}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}}, "reader_count_by_country"=>{"Korea (South)"=>1, "United States"=>1, "France"=>1}, "group_count"=>8}

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  • {"files"=>["https://ndownloader.figshare.com/files/1524836"], "description"=>"<p>A: Cumulative number of influenza cases expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model. B: Cumulative number of influenza deaths expected to be averted by quadrivalent vaccination compared with trivalent vaccination in each year of the model.</p>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health", "cases", "deaths", "averted", "quadrivalent", "vaccination"], "article_id"=>1049099, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437.g003", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Influenza_cases_and_deaths_averted_by_quadrivalent_vaccination_over_time_/1049099", "title"=>"Influenza cases and deaths averted by quadrivalent vaccination over time.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-06-06 02:48:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/1524838"], "description"=>"<p>A: cost-effectiveness plane; B: cost-effectiveness acceptability curve. ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year.</p>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health"], "article_id"=>1049101, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437.g004", "stats"=>{"downloads"=>1, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Probabilistic_sensitivity_analysis_/1049101", "title"=>"Probabilistic sensitivity analysis.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-06-06 02:48:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/1524839"], "description"=>"<p>PEP, post-exposure prophylaxis; QALY, quality-adjusted life-year.</p>a<p>All deaths due to complications, as it was assumed that mortality from uncomplicated influenza was 0.</p>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health"], "article_id"=>1049102, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437.t005", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Base_case_results_/1049102", "title"=>"Base case results.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-06 02:48:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/1524840"], "description"=>"a<p>No difference in input values between healthy and at-risk populations.</p>b<p>Duration 7.5 days without antiviral treatment, 5.0 days with antiviral treatment.</p>c<p>Duration 5.4 days. Outpatient-treated complications assumed to have the same duration as hospitalised complications, and the same disutility as influenza. Disutilities and durations are identical for all types of complications.</p>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health"], "article_id"=>1049103, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437.t004", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Input_data_for_utilities_/1049103", "title"=>"Input data for utilities.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-06 02:48:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/1524841"], "description"=>"a<p>All deaths due to complications, as it was assumed that mortality from uncomplicated influenza was 0.</p>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health"], "article_id"=>1049105, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437.t006", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Results_in_the_first_year_/1049105", "title"=>"Results in the first year.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-06 02:48:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/1524843"], "description"=>"a<p>No difference in input values between healthy and at-risk populations.</p>b<p>Adjusted for the proportion of the 0–4 age group falling within the product license (i.e. 38.62%).</p>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health", "efficacy"], "article_id"=>1049106, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437.t001", "stats"=>{"downloads"=>1, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Input_data_for_vaccine_efficacy_and_coverage_/1049106", "title"=>"Input data for vaccine efficacy and coverage.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-06 02:48:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/1524844"], "description"=>"a<p>4.9% of hospitalised patients are treated in intensive care <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0098437#pone.0098437-Turner1\" target=\"_blank\">[24]</a>, and this cost was included in the cost of hospitalization.</p><p>A&E, accident and emergency; CNS, central nervous system; GI, gastrointestinal; GP, general practitioner; LOS, length of stay; OM, otitis media; PEP, post-exposure prophylaxis; URTI, upper respiratory tract infection.</p>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health"], "article_id"=>1049107, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437.t003", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Input_data_for_costs_/1049107", "title"=>"Input data for costs.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-06 02:48:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/1524845"], "description"=>"a<p>No difference in input values between healthy and at-risk populations.</p>b<p>Identical for influenza A and B.</p>c<p>97.0% present to a GP and 3.0% to A & E, in all age groups <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0098437#pone.0098437-Tappenden1\" target=\"_blank\">[23]</a>.</p>d<p>No difference between cases presenting to GP or A & E, or not seeking medical advice.</p>e<p>Risk of death assumed to be the same for all complications.</p><p>A&E, accident and emergency; GP, general practitioner.</p>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health", "age-dependent"], "article_id"=>1049108, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437.t002", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Input_data_for_age_dependent_probabilities_/1049108", "title"=>"Input data for age-dependent probabilities.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-06 02:48:32"}
  • {"files"=>["https://ndownloader.figshare.com/files/1524846"], "description"=>"<div><p>Objective</p><p>To estimate the potential cost-effectiveness of quadrivalent influenza vaccine compared with trivalent influenza vaccine in the UK.</p><p>Methods</p><p>A lifetime, multi-cohort, static Markov model was constructed, with nine age groups each divided into healthy and at-risk categories. Influenza A and B were accounted for separately. The model was run in one-year cycles for a lifetime (maximum age: 100 years). The analysis was from the perspective of the UK National Health Service. Costs and benefits were discounted at 3.5%. 2010 UK vaccination policy (vaccination of people at risk and those aged ≥65 years) was applied. Herd effect was not included. Inputs were derived from national databases and published sources where possible. The quadrivalent influenza vaccine price was not available when the study was conducted. It was estimated at £6.72,15% above the trivalent vaccine price of £5.85. Sensitivity analyses used an incremental price of up to 50%.</p><p>Results</p><p>Compared with trivalent influenza vaccine, the quadrivalent influenza vaccine would be expected to reduce the numbers of influenza cases by 1,393,720, medical visits by 439,852 complications by 167,357, hospitalisations for complications by 26,424 and influenza deaths by 16,471. The estimated base case incremental cost-effectiveness ratio (ICER) was £5,299/quality-adjusted life-year (QALY). Sensitivity analyses indicated that the ICER was sensitive to changes in circulation of influenza virus subtypes and vaccine mismatch; all other parameters had little effect. In 96% of simulations the ICER was <£20,000/QALY. Since this analysis was completed, quadrivalent influenza vaccine has become available in the UK at a list price of £9.94. Using this price in the model, the estimated ICER for quadrivalent compared with trivalent vaccination was £27,378/QALY, still within the NICE cost-effectiveness threshold (£20,000-£30,000).</p><p>Conclusions</p><p>Quadrivalent influenza vaccine could reduce influenza disease burden and would be cost-effective compared with trivalent influenza vaccine in elderly people and clinical risk groups in the UK.</p></div>", "links"=>[], "tags"=>["immunology", "Vaccination and immunization", "vaccines", "Clinical immunology", "immunity", "microbiology", "Virology", "Viral vaccines", "health care", "Health economics", "Infectious diseases", "Viral diseases", "influenza", "Public and occupational health", "cost-effectiveness", "quadrivalent", "trivalent", "groups", "multi-cohort"], "article_id"=>1049109, "categories"=>["Biological Sciences"], "users"=>["Laure-Anne Van Bellinghen", "Genevieve Meier", "Ilse Van Vlaenderen"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098437", "stats"=>{"downloads"=>7, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_Potential_Cost_Effectiveness_of_Quadrivalent_versus_Trivalent_Influenza_Vaccine_in_Elderly_People_and_Clinical_Risk_Groups_in_the_UK_A_Lifetime_Multi_Cohort_Model_/1049109", "title"=>"The Potential Cost-Effectiveness of Quadrivalent versus Trivalent Influenza Vaccine in Elderly People and Clinical Risk Groups in the UK: A Lifetime Multi-Cohort Model", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-06 02:48:32"}

PMC Usage Stats | Further Information

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Relative Metric

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