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Cost Effectiveness of Quadrivalent Influenza Vaccines Compared with Trivalent Influenza Vaccines in Young Children and Older Adults in Korea

Author

Listed:
  • Yun-Kyung Kim

    (Korea University Ansan Hospital)

  • Joon Young Song

    (Korea University College of Medicine)

  • Hyeongap Jang

    (GSK)

  • Tae Hyun Kim

    (Yonsei University)

  • Heejo Koo

    (Yonsei University)

  • Lijoy Varghese

    (GSK)

  • Euna Han

    (Yonsei University
    Yonsei University)

Abstract

Introduction Trivalent influenza vaccines (TIVs) are currently reimbursed for subjects aged ≥ 65 years and children between 6 and 59 months of age under a national immunization program in South Korea. Quadrivalent influenza vaccines (QIVs) are expected to address the potential problem of influenza B-lineage mismatch for TIVs. Objective The objective of this analysis was to compare the cost effectiveness of QIV versus TIV in children aged 6–59 months and older adults ≥ 65 years of age in South Korea. Methods A 1-year static population model was employed to compare the costs and outcomes of a QIV vaccination program compared with TIV in children aged 6–59 months and older adults ≥ 65 years of age in South Korea. Influenza-related parameters (probabilities, health resource use, and costs) were derived from an analysis of the National Health Insurance System claims database between 2010 and 2013 under a broad and narrow set of International Classification of Diseases, Tenth Revision (ICD-10) codes used to identify influenza. Other inputs were extracted from published literature. Incremental cost-effectiveness ratios (2016 South Korean Won [KRW] per quality-adjusted life-year [QALY] gained) were estimated using a ‘limited’ societal perspective as per the Korean pharmacoeconomic guidelines. QALYs lost due to premature mortality were discounted at 5% annually. Results For both age groups combined, under the narrow definition of influenza, QIV is expected to prevent nearly 16,000 (2923 in children and 13,011 in older adults) medically attended influenza cases, nearly 8000 (672 in children, 7048 in older adults) cases of complications, and over 230 (0 in children, 238 in older adults) deaths annually compared with TIV. The impact of using QIV versus TIV in this setting translates into savings of KRW 24 billion (KRW 0.6 billion in children, KRW 23.4 billion in older adults) in annual medical costs, and over 2100 (18 in children, 2084 in older adults) QALYs. Under the broad definition, the corresponding results are over 190,000 (50,697 in children, 140,644 in older adults) influenza cases, over 37,000 (12,623 in children, 24,526 in older adults) complications, 270 deaths (0 in children, 270 in older adults), KRW 94.22 billion (KRW 16 billion in children, KRW 78.2 billion in older adults), and over 3500 QALYs saved (316 in children, 3260 in older adults). Conclusion The use of QIV over TIV was estimated to not be cost effective in children 6–59 months of age, but cost saving in older adults, using the narrow definition of influenza; however, QIV use was cost saving in both age groups using the broad definition. QIV is expected to yield more benefits in older adults ≥ 65 years of age than in children aged 6–59 months due to higher influenza-related mortality and costs among the older adults. Further analyses considering the indirect effects of influenza vaccination in children are required.

Suggested Citation

  • Yun-Kyung Kim & Joon Young Song & Hyeongap Jang & Tae Hyun Kim & Heejo Koo & Lijoy Varghese & Euna Han, 2018. "Cost Effectiveness of Quadrivalent Influenza Vaccines Compared with Trivalent Influenza Vaccines in Young Children and Older Adults in Korea," PharmacoEconomics, Springer, vol. 36(12), pages 1475-1490, December.
    • Handle: RePEc:spr:pharme:v:36:y:2018:i:12:d:10.1007_s40273-018-0715-5
    DOI: 10.1007/s40273-018-0715-5
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    References listed on IDEAS

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    1. Hong, Yoo Soo, 2005. "Republic of Korea," Documentos de Proyectos 4161, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    2. Takeru Shiroiwa & Yoon‐Kyoung Sung & Takashi Fukuda & Hui‐Chu Lang & Sang‐Cheol Bae & Kiichiro Tsutani, 2010. "International survey on willingness‐to‐pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 422-437, April.
    3. L. Gerlier & M. Lamotte & S. Grenèche & X. Lenne & F. Carrat & C. Weil-Olivier & O. Damm & M. Schwehm & M. Eichner, 2017. "Assessment of Public Health and Economic Impact of Intranasal Live-Attenuated Influenza Vaccination of Children in France Using a Dynamic Transmission Model," Applied Health Economics and Health Policy, Springer, vol. 15(2), pages 261-276, April.
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    1. Maria Ganczak & Paulina Dubiel & Marzena Drozd-Dąbrowska & Marcin Korzeń, 2022. "Does Vaccinating against Influenza in a Given Epidemic Season Have an Impact on Vaccination in the Next Season: A Follow-Up Study," IJERPH, MDPI, vol. 19(13), pages 1-11, June.

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