The potential global health impact and cost-effectiveness of next-generation influenza vaccines: A modelling analysis.

IF 15.8 1区 医学 Q1 Medicine
Lucy Goodfellow, Simon R Procter, Mihaly Koltai, Naomi R Waterlow, Johnny A N Filipe, Carlos K H Wong, Edwin van Leeuwen, Rosalind M Eggo, Mark Jit
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引用次数: 0

Abstract

Background: Next-generation influenza vaccines (NGIVs) are in development and have the potential to achieve substantial reductions in influenza burden, with resulting widespread health and economic benefits. The prices at which their market can be sustained and which vaccination strategies may maximise health impact and cost-effectiveness, particularly in low- and middle-income countries, are unknown, yet such an understanding could provide a valuable tool for vaccine development and investment decision-making at a national and global level. To address this evidence gap, we projected the health and economic impact of NGIVs in 186 countries and territories.

Methods and findings: We inferred current influenza transmission parameters from World Health Organization (WHO) FluNet data in regions defined by their seasonal influenza timing and positivity, and projected 30 years of influenza epidemics, accounting for demographic changes. We considered vaccines including current seasonal vaccines, vaccines with increased efficacy, duration, and breadth of protection, and universal vaccines, defined in line with WHO Preferred Product Characteristics. We estimated cost-effectiveness of different vaccination scenarios using novel estimates of key health outcomes and costs. NGIVs have the potential to substantially reduce influenza burden: compared to no vaccination, vaccinating 50% of children aged under 18 annually prevented 1.3 (95% uncertainty range (UR): 1.2-1.5) billion infections using current vaccines, 2.6 (95% UR: 2.4-2.9) billion infections using vaccines with improved efficacy or breadth, and 3.0 (95% UR: 2.7-3.3) billion infections using universal vaccines. In many countries, NGIVs were cost-effective at higher prices than typically paid for existing seasonal vaccines. However, tiered prices may be necessary for improved vaccines to be cost-effective in lower income countries. This study is limited by the availability of accurate data on influenza incidence and influenza-associated health outcomes and costs. Furthermore, the model involves simplifying assumptions around vaccination coverage and administration, and does not account for societal costs or budget impact of NGIVs. How NGIVs will compare to the vaccine types considered in this model when developed is unknown. We conducted sensitivity analyses to investigate key model parameters.

Conclusions: This study highlights the considerable potential health and economic benefits of NGIVs, but also the variation in cost-effectiveness between high-income and low- and middle-income countries. This work provides a framework for long-term global cost-effectiveness evaluations, and the findings can inform a pathway to developing NGIVs and rolling them out globally.

下一代流感疫苗的潜在全球健康影响和成本效益:建模分析。
背景:下一代流感疫苗(ngiv)正在开发中,有可能大幅减少流感负担,从而带来广泛的健康和经济效益。它们的市场能够维持的价格以及哪些疫苗接种战略可以最大限度地提高健康影响和成本效益,特别是在低收入和中等收入国家,目前尚不清楚,但这种了解可以为国家和全球一级的疫苗开发和投资决策提供宝贵的工具。为了解决这一证据差距,我们预测了非政府组织在186个国家和地区的健康和经济影响。方法和发现:我们从世界卫生组织(WHO) fluet数据中推断出当前流感传播参数,这些数据是根据季节性流感时间和阳性情况定义的,并预测了30年的流感流行,考虑到人口变化。我们考虑的疫苗包括当前的季节性疫苗,具有更高效力、持续时间和保护范围的疫苗,以及根据世卫组织首选产品特性定义的通用疫苗。我们使用对关键健康结果和成本的新估计估计了不同疫苗接种方案的成本效益。ngiv具有显著减轻流感负担的潜力:与不接种疫苗相比,为50%的18岁以下儿童接种疫苗,使用现有疫苗可预防1.3亿(95%不确定范围:12 - 15)亿感染,使用效力或广度有所改善的疫苗可预防26亿(95%不确定范围:24 - 29)亿感染,使用通用疫苗可预防30亿(95%不确定范围:27 - 33)亿感染。在许多国家,非政府免疫机构比通常支付的现有季节性疫苗价格更高,具有成本效益。然而,为了使改进的疫苗在低收入国家具有成本效益,分级价格可能是必要的。这项研究受到流感发病率和流感相关健康结果和成本的准确数据的限制。此外,该模型涉及简化有关疫苗接种覆盖和管理的假设,并且没有考虑到非政府免疫机构的社会成本或预算影响。ngiv在开发时将如何与该模型中考虑的疫苗类型进行比较尚不清楚。我们对关键模型参数进行了敏感性分析。结论:本研究强调了非giv的巨大潜在健康和经济效益,但也强调了高收入国家与低收入和中等收入国家之间成本效益的差异。这项工作为长期的全球成本效益评估提供了一个框架,研究结果可以为发展非政府组织和在全球推广它们提供途径。
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来源期刊
PLoS Medicine
PLoS Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
17.60
自引率
0.60%
发文量
227
审稿时长
4-8 weeks
期刊介绍: PLOS Medicine is a prominent platform for discussing and researching global health challenges. The journal covers a wide range of topics, including biomedical, environmental, social, and political factors affecting health. It prioritizes articles that contribute to clinical practice, health policy, or a better understanding of pathophysiology, ultimately aiming to improve health outcomes across different settings. The journal is unwavering in its commitment to uphold the highest ethical standards in medical publishing. This includes actively managing and disclosing any conflicts of interest related to reporting, reviewing, and publishing. PLOS Medicine promotes transparency in the entire review and publication process. The journal also encourages data sharing and encourages the reuse of published work. Additionally, authors retain copyright for their work, and the publication is made accessible through Open Access with no restrictions on availability and dissemination. PLOS Medicine takes measures to avoid conflicts of interest associated with advertising drugs and medical devices or engaging in the exclusive sale of reprints.
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