Introduction

Influenza surveillance in Argentina reported influenza-like illness at a rate of 3500/100,000, a hospitalization rate of 15.5/100,000, and a death rate of 0.32/100,000 annually in adults aged over 65 years. The high burden of disease may be due to a combination of immunosenescence and the suboptimal clinical effectiveness of conventional, non-adjuvanted influenza vaccines in this age group. There is a clinical need for more effective influenza vaccines in this population. This study evaluated the cost-effectiveness of an MF59®-adjuvanted trivalent influenza vaccine (aTIV) in adults aged over 65 years in Argentina compared with the non-adjuvanted trivalent influenza vaccine (TIV) used under the current national vaccination policy.

Methods

A decision tree cost-effectiveness model was developed to estimate the cost-effectiveness of switching from TIV to aTIV in Argentinian older adults. The model compared cost and health benefits of vaccination in one influenza season from the payer perspective. The main predictions included survival, quality-adjusted survival, and costs. Model inputs were sourced from Argentina or internationally where local data was considered inaccurate. Vaccine efficacy assumptions were extracted from recently published, peer-reviewed scientific literature.

Results

Switching from TIV to aTIV would result in 170 deaths averted and 1310 incremental quality-adjusted life years (QALYs) gained. The incremental cost-effectiveness ratio per QALY was US $2660.59 from the payer perspective. In all sensitivity analyses, aTIV remained highly cost-effective. The probabilistic sensitivity analyses showed a 95% CI per QALY of US $113.74–7721.67.

Conclusion

Introducing an adjuvanted influenza vaccine in Argentina is potentially beneficial and cost-effective relative to the currently-used TIV through the reduction of disease burden and utilization of healthcare resources.

中文翻译：

---

在阿根廷为老年人引入MF59佐剂的三价流感疫苗的成本效益

介绍

阿根廷的流感监测报告称，65岁以上的成年人每年的类流感疾病发病率为3500 / 100,000，住院率为15.5 / 100,000，死亡率为0.32 / 100,000。疾病的高负担可能是由于该年龄组中常规的非辅助流感疫苗的免疫衰老和临床效果欠佳所致。在该人群中，临床上需要更有效的流感疫苗。这项研究评估了MF59®佐剂三价流感疫苗（aTIV）在阿根廷65岁以上成年人中的成本效果，与当前国家疫苗接种政策中使用的非佐剂三价流感疫苗（TIV）相比。

方法

建立了决策树成本效益模型，以估计阿根廷老年人从TIV转换为aTIV的成本效益。该模型从付款人的角度比较了一个流感季节接种疫苗的成本和健康益处。主要预测包括生存期，质量调整后的生存期和成本。模型输入来自阿根廷或国际上，当地数据被认为不准确。疫苗功效假设摘自最近发表的，经过同行评审的科学文献。

结果

从TIV转向aTIV将避免170例死亡，并增加1310例质量调整生命年（QALY）。从付款人的角度来看，每个QALY的增量成本效益比为2660.59美元。在所有敏感性分析中，aTIV仍然具有很高的成本效益。概率敏感性分析显示，每个QALY的95％CI为113.74–7721.67美元。

结论

相对于当前使用的TIV，通过减少疾病负担和医疗资源的利用，在阿根廷引入佐剂型流感疫苗具有潜在的益处和成本效益。