Assessment of Public Health and Economic Impact of Intranasal Live-Attenuated Influenza Vaccination of Children in France Using a Dynamic Transmission Model

L. Gerlier (), M. Lamotte, S. Grenèche, X. Lenne, F. Carrat, C. Weil-Olivier, O. Damm, M. Schwehm and M. Eichner
Additional contact information
L. Gerlier: QuintilesIMS Real-World Evidence Solutions
M. Lamotte: QuintilesIMS Real-World Evidence Solutions
S. Grenèche: AstraZeneca
X. Lenne: University Lille Nord de France
F. Carrat: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136)
C. Weil-Olivier: University Paris VII
O. Damm: Bielefeld University
M. Schwehm: ExploSYS GmbH
M. Eichner: University of Tübingen

Applied Health Economics and Health Policy, 2017, vol. 15, issue 2, No 12, 276 pages

Abstract: Abstract Objectives We estimated the epidemiological and economic impact of extending the French influenza vaccination programme from at-risk/elderly (≥65 years) only to healthy children (2–17 years). Methods A deterministic, age-structured, dynamic transmission model was used to simulate the transmission of influenza in the French population, using the current vaccination coverage with trivalent inactivated vaccine (TIV) in at-risk/elderly individuals (current strategy) or gradually extending the vaccination to healthy children (aged 2–17 years) with intranasal, quadrivalent live-attenuated influenza vaccine (QLAIV) from current uptake up to 50% (evaluated strategy). Epidemiological, medical resource use and cost data were taken from international literature and country-specific information. The model was calibrated to the observed numbers of influenza-like illness visits/year. The 10-year number of symptomatic cases of confirmed influenza and direct medical costs (‘all-payer’) were calculated for the 0–17- (direct and indirect effects) and ≥18-year-old (indirect effect). The incremental cost-effectiveness ratio (ICER) was calculated for the total population, using a 4% discount rate/year. Results Assuming 2.3 million visits/year and 1960 deaths/year, the model calibration yielded an all-year average basic reproduction number (R 0) of 1.27. In the population aged 0–17 years, QLAIV prevented 865,000 influenza cases/year (58.4%), preventing 10-year direct medical expenses of €374 million. In those aged ≥18 years with unchanged TIV coverage, 1.2 million cases/year were averted (27.6%) via indirect effects (additionally prevented expenses, €457 million). On average, 613 influenza-related deaths were averted annually overall. The ICER was €18,001/life-year gained. The evaluated strategy had a 98% probability of being cost-effective at a €31,000/life-year gained threshold. Conclusions The model demonstrated strong direct and indirect benefits of protecting healthy children against influenza with QLAIV on public health and economic outcomes in France.

Keywords: Influenza; Influenza Vaccine; Influenza Vaccination; Acute Otitis Medium; Vaccination Coverage (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s40258-016-0296-4

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