日本老年人使用高剂量流感疫苗的成本效益和公共卫生影响。

IF 3 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Journal of Medical Economics Pub Date : 2025-12-01 Epub Date: 2025-04-08 DOI:10.1080/13696998.2025.2488151
Caroline de Courville, Chiho Tadera, Takeshi Arashiro, Florence Bianic, Mafalda Costa, Mohit Joshi, Xinyu Wang
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引用次数: 0

摘要

背景:与标准剂量(SD)相比,高剂量(HD)流感疫苗已显示出优越的疗效和可接受的安全性,已在许多国家获得上市许可。本研究从医疗保健支付者的角度评估了日本老年人(OAs) HD与SD的公共卫生影响和成本效益。方法:采用决策树模型评估每种疫苗接种策略的健康结果,模拟流感病例、门诊/急诊(ED)访问量、住院率和死亡率,时间范围为一年。增量成本-效果比(ICER)在日本支付意愿(WTP)阈值下进行评估。基础病例分析认为流感疫苗仅对流感住院有效,而补充分析反映了流感疫苗对肺炎和流感(P&I)、呼吸道和心肺疾病住院的有效性,这些患者年龄≥65岁,可能与流感有关。情景分析将目标人群扩展到60-64岁的高危人群。采用敏感性分析评估不确定性。结果:在基础病例中,从SD转换为HD每年可预防174,863例流感病例,121,084例门诊和614例急诊科就诊。此外,接种HD疫苗可避免5777例流感住院和2406例与流感相关的死亡。在WTP阈值为¥5,000,000/质量调整生命年(QALY)时,发现HD疫苗具有成本效益,ICER为¥4,876,512/(QALY)。敏感性分析证实了这些发现的稳健性。补充分析显示,在公共卫生、经济影响和ICERs方面,考虑到流感疫苗对可能与流感相关的P&I、呼吸道和心肺住院的疗效,结果显著改善。结论:与SD相比,HD疫苗在日本具有较高的经济价值。实施HD疫苗可有效减轻日本oa保健设施的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cost-effectiveness and public health impact of using high dose influenza vaccine in the Japanese older adults.

Background: High-dose (HD) influenza vaccine, which has demonstrated superior efficacy and acceptable safety compared to standard-dose (SD), has market authorization in many countries. This study evaluated the public-health impact and cost-effectiveness of HD versus SD in Japanese older-adults (OAs) from healthcare payer-perspective.

Methods: Decision-tree model was employed assessing health outcomes for each vaccination strategy, simulating influenza cases, outpatient/emergency department (ED) visits, hospitalizations, and mortality, over one-year time-horizon. Incremental cost-effectiveness ratios (ICER) were assessed at Japanese willingness-to-pay (WTP) threshold. Base-case analysis considered influenza vaccines effective against influenza hospitalizations only, whereas complementary analyses reflected their efficacies against Pneumonia and Influenza (P&I), respiratory and cardiorespiratory hospitalizations possibly related to influenza among individuals ≥65 years. Scenario analysis extended target population to at-risk individuals aged 60-64 years. Uncertainty was assessed using sensitivity analyses.

Results: In base-case, switching from SD to HD prevented 174,863 influenza cases, 121,084 outpatient and 614 ED visits, annually. Further, 5,777 influenza hospitalizations, and 2,406 deaths related to influenza were avoided with HD vaccine. The HD vaccine was found to be a cost-effective strategy at WTP threshold of ¥5,000,000/Quality-Adjusted-Life-Years (QALY) with ICER of ¥4,876,512/(QALY). Sensitivity analyses confirmed the robustness of these findings. Complementary analyses showed notably improved outcomes, in terms of public-health, economic impact, and ICERs, when considering efficacy of influenza vaccines against P&I, respiratory, and cardiorespiratory hospitalizations possibly related to influenza.

Conclusion: These results indicate that HD vaccine has a high economic value in Japan compared to SD. Implementing HD vaccine could effectively alleviate the burden on healthcare facilities for Japanese OAs.

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来源期刊
Journal of Medical Economics
Journal of Medical Economics HEALTH CARE SCIENCES & SERVICES-MEDICINE, GENERAL & INTERNAL
CiteScore
4.50
自引率
4.20%
发文量
122
期刊介绍: Journal of Medical Economics'' mission is to provide ethical, unbiased and rapid publication of quality content that is validated by rigorous peer review. The aim of Journal of Medical Economics is to serve the information needs of the pharmacoeconomics and healthcare research community, to help translate research advances into patient care and be a leader in transparency/disclosure by facilitating a collaborative and honest approach to publication. Journal of Medical Economics publishes high-quality economic assessments of novel therapeutic and device interventions for an international audience
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