法国细胞流感疫苗的成本效益。

IF 5.5 3区 医学 Q1 IMMUNOLOGY Expert Review of Vaccines Pub Date : 2024-01-01 Epub Date: 2024-10-24 DOI:10.1080/14760584.2024.2417854
Gaetan Gavazzi, Marc Paccalin, Quentin Berkovitch, Henri Leleu, Romain Moreau, Emanuele Ciglia, Nansa Burlet, Joaquin Mould-Quevedo
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引用次数: 0

摘要

目标:法国每年因流感导致的全科医生就诊人数超过 100 万,住院人数约 2 万,死亡人数约 9000。本研究评估了针对 65 岁以下人群的细胞型四价流感疫苗(QIVc)与鸡蛋型四价流感疫苗(QIVe)的成本效益:方法:根据法国2011年至2019年的数据,校准了一个年龄结构的易感-暴露-感染-康复(SEIR)传播模型,以代表一个平均流感季节,该模型整合了一个估计群体间接触率的接触矩阵。该模型评估了流行病学、经济和效用结果,包括现有文献和法国国家数据中的疫苗效果和医疗成本。此外,还包括对感染和住院造成的生活质量的调整。通过情景分析和敏感性分析探讨了不确定性:结果:与 QIVe 相比,QIVc 显著降低了医疗保健的使用率和死亡率,在法国预防了 49,946 次全科医生会诊、1,087 次住院治疗和 231 例死亡。尽管初始投资为 760 万欧元,但 QIVc 净节省了 1200 万欧元的医疗开支,成为一种主要的成本节约策略。概率敏感性分析表明,在10,000次模拟中,有78%的人认为QIVc占优势:结论:在法国免疫计划中引入细胞型流感疫苗可预防流感病例、住院治疗和死亡,同时与鸡蛋型流感疫苗相比可降低成本。
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Cost-effectiveness of cell-based influenza vaccine in France.

Objectives: Annually in France, influenza results in over one million GP consultations, around 20,000 hospitalizations, and approximately 9,000 deaths. This study assesses the cost-effectiveness of cell-based quadrivalent influenza vaccine (QIVc) for those under 65, which enhances effectiveness avoiding egg-adaptation, compared to egg-based quadrivalent influenza vaccine (QIVe).

Methods: An age-structured susceptible-exposed-infected-recovered (SEIR) transmission model, calibrated to represent an average influenza season based on French data from 2011 to 2019, integrates a contact matrix estimating intergroup contact rates. Evaluating epidemiological, economic and utility outcomes, the model includes vaccine effectiveness and medical costs from the existing literature and French national data. Adjustments to quality of life due to infection and hospitalization are also included. Uncertainty is explored through scenario and sensitivity analyses.

Results: Compared to QIVe, QIVc significantly reduces healthcare utilization and mortality, preventing 49,946 GP consultations, 1,087 hospitalizations, and 231 deaths in France. Despite an initial investment of 7.6 million euros, QIVc achieves a net saving of 12 million euros in healthcare expenditures, making it a dominant cost-saving strategy. Probabilistic sensitivity analyses indicate dominance in 78% of 10,000 simulations.

Conclusions: Introducing cell-based influenza vaccines in the French immunization program prevents influenza cases, hospitalizations, death, while reducing costs versus egg-based influenza vaccines.

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来源期刊
Expert Review of Vaccines
Expert Review of Vaccines 医学-免疫学
CiteScore
9.10
自引率
3.20%
发文量
136
审稿时长
4-8 weeks
期刊介绍: Expert Review of Vaccines (ISSN 1476-0584) provides expert commentary on the development, application, and clinical effectiveness of new vaccines. Coverage includes vaccine technology, vaccine adjuvants, prophylactic vaccines, therapeutic vaccines, AIDS vaccines and vaccines for defence against bioterrorism. All articles are subject to rigorous peer-review. The vaccine field has been transformed by recent technological advances, but there remain many challenges in the delivery of cost-effective, safe vaccines. Expert Review of Vaccines facilitates decision making to drive forward this exciting field.
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