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High-dose flu vaccine more cost-effective than standard dose in older patients
A high-dose trivalent inactive influenza vaccine appeared to be more cost-effective than the standard dose in older patients, according to recent findings.
Ayman Chit, PhD, an investigator for Sanofi Pasteur, and colleagues conducted an economic analysis of a standard-dose vs. high-dose influenza vaccine in 31,989 patients aged 65 years and older enrolled in the FIM12 study. Participants were randomly allocated to receive either dose during the 2011 to 2012 and the 2012 to 2013 influenza seasons.
The researchers assessed Medicare costs based on health care utilization, including the number of days spent in the hospital. The unit cost of each vaccine also was factored into the calculations (high-dose, $31.82 vs. standard dose, $12.04). The number of quality-adjusted life-years (QALYs) was estimated using life expectancy data from the National Center for Health Statistics.
Patients in the high-dose vaccine arm had lower mean medical costs than patients receiving standard-dose vaccine ($1,376.72 vs. $1,492.64), saving approximately $115.92 (95% CI, –264.18 to 35.48). Those receiving the high-dose vaccine also incurred lower societal costs vs. the standard-dose group ($1,506.48 vs. $1,634.50), saving roughly $128.02 (95% CI, –286.89 to 33.30).
Ninety-five percent of the total health care payer costs and 87% of the total societal costs were attributed to hospital admissions. The mean hospital admission for each participant was 0.0937 in the high-dose group compared with 0.1017 among the standard-dose patients.
Patients receiving the high-dose vaccine gained a mean 8.1502 QALYS per participant vs. 8.1499 QALYs in the standard-dose group.
A probabilistic sensitivity analysis using bootstrapping showed that the high-dose vaccine was 93% likely to be more cost-effective than the standard dose.
“There seems to be a very strong economic case for adults aged 65 years and older to receive high-dose vaccines, which supports Medicare’s policy of reimbursing people in this age group fully for the vaccine,” Mark Jit, PhD, of the Modelling and Economics Unit at Public Health England, wrote in a related editorial. “However, influenza vaccine policy is not simply a choice between two vaccines. The present trivalent high-dose vaccine joins an increasingly crowded market-place with quadrivalent, adjuvanted, and live-attenuated vaccines for different groups available or in the pipeline.” – by Jen Byrne
Disclosures: The study was funded by Sanofi Pasteur. Chit reports being a paid employee of Sanofi Pasteur. Jit reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.