See the published version of this article at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Impact of quadrivalent influenza vaccines in Brazil: a cost-effectiveness analysis using an influenza transmission model
Louis Boiron
Sanofi Pasteur
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2801-7253
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background Influenza epidemics significantly weight on the Brazilian healthcare system and its society. Public health authorities have progressively expanded recommendations for vaccination against influenza, particularly to the pediatric population. However, the potential mismatch between the trivalent influenza vaccine (TIV) strains and those circulating during the season remains an issue. Quadrivalent vaccines improves vaccines effectiveness by preventing any potential mismatch on influenza B lineages.
Methods We evaluate the public health and economic benefits of the switch from TIV to QIV for the pediatric influenza recommendation (6mo-5yo) by using a dynamic epidemiological model able to consider the indirect impact of vaccination. Results of the epidemiological model are then imputed in a health-economic model adapted to the Brazilian context. We perform deterministic and probabilistic sensitivity analysis to account for both epidemiological and economical sources of uncertainty.
Results Our results show that switching from TIV to QIV in the Brazilian pediatric population would prevent 406.600 symptomatic cases, 11.300 hospitalizations and almost 400 deaths by influenza season. This strategy would save 3400 life-years yearly. Incremental cost-effectiveness ratios for the switch would be R$49.700 per life-year saved and R$26.800 per quality-adjusted life-year gained from a public payer perspective, and even more cost-effective from a societal perspective. Our results are qualitatively similar in our sensitivity analysis.
Conclusions Our analysis shows that switching from TIV to QIV to protect children aged 6mo to 5yo in the Brazilian influenza epidemiological context could have a strong public health impact and represent a cost-effective strategy from a public payer perspective, and a highly cost-effective one from a societal perspective.
Keywords
QIV, quadrivalent, public health, cost-effectiveness, vaccine, influenza, Brazil
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
This is a list of supplementary files associated with this preprint. Click to download.
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 10 Jan, 2020
Published
On 09 Sep, 2020
No community comments so far
Review #2 received
Received 10 Mar, 2020
Editorial decision: Minor revision
On 10 Mar, 2020
Reviewer #2 agreed
On 19 Feb, 2020
Review #1 received
Received 22 Jan, 2020
Reviewer #1 agreed
On 13 Jan, 2020
Reviewers invited
Invitations sent on 08 Jan, 2020
Editor assigned
On 19 Dec, 2019
First submitted
On 18 Dec, 2019
Submission checks complete
On 18 Dec, 2019
Editor invited
On 18 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
Learn more about our company.
This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Impact of quadrivalent influenza vaccines in Brazil: a cost-effectiveness analysis using an influenza transmission model
Louis Boiron
Sanofi Pasteur
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2801-7253
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 10 Jan, 2020
Published
On 09 Sep, 2020
No community comments so far
Review #2 received
Received 10 Mar, 2020
Editorial decision: Minor revision
On 10 Mar, 2020
Reviewer #2 agreed
On 19 Feb, 2020
Review #1 received
Received 22 Jan, 2020
Reviewer #1 agreed
On 13 Jan, 2020
Reviewers invited
Invitations sent on 08 Jan, 2020
Editor assigned
On 19 Dec, 2019
First submitted
On 18 Dec, 2019
Submission checks complete
On 18 Dec, 2019
Editor invited
On 18 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background Influenza epidemics significantly weight on the Brazilian healthcare system and its society. Public health authorities have progressively expanded recommendations for vaccination against influenza, particularly to the pediatric population. However, the potential mismatch between the trivalent influenza vaccine (TIV) strains and those circulating during the season remains an issue. Quadrivalent vaccines improves vaccines effectiveness by preventing any potential mismatch on influenza B lineages.
Methods We evaluate the public health and economic benefits of the switch from TIV to QIV for the pediatric influenza recommendation (6mo-5yo) by using a dynamic epidemiological model able to consider the indirect impact of vaccination. Results of the epidemiological model are then imputed in a health-economic model adapted to the Brazilian context. We perform deterministic and probabilistic sensitivity analysis to account for both epidemiological and economical sources of uncertainty.
Results Our results show that switching from TIV to QIV in the Brazilian pediatric population would prevent 406.600 symptomatic cases, 11.300 hospitalizations and almost 400 deaths by influenza season. This strategy would save 3400 life-years yearly. Incremental cost-effectiveness ratios for the switch would be R$49.700 per life-year saved and R$26.800 per quality-adjusted life-year gained from a public payer perspective, and even more cost-effective from a societal perspective. Our results are qualitatively similar in our sensitivity analysis.
Conclusions Our analysis shows that switching from TIV to QIV to protect children aged 6mo to 5yo in the Brazilian influenza epidemiological context could have a strong public health impact and represent a cost-effective strategy from a public payer perspective, and a highly cost-effective one from a societal perspective.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7