The Economic Value of a Multi-Year Universal Influenza Vaccine

Background:  Limitations of the current annual influenza vaccine have led to ongoing efforts to develop a "universal" influenza vaccine, i.e., one that targets a conserved portion of the influenza virus so that the coverage of a single vaccination can persist for multiple years. 

Objectives:  To estimate the potential economic value (cost-effectiveness) of a "universal" influenza vaccine compared to standard annual influenza vaccine or no vaccine, from the third party perspective in older adults (>50 years old).

Methods: 

Probabilistic sensitivity analyses explored the effects of simultaneously varying the values of each parameter across the following ranges: cost of universal vaccine ($100-$300), universal vaccine efficacy (25%-75%), starting age of the individual (50-70 years old), compliance with annual vaccine (100%, 75%, 50%, 25%), and the duration of universal vaccine protection (5 or 10 years). 

Results:  Both vaccines were cost-effective compared to no vaccine. Universal vaccine was the more favorable strategy when annual vaccine compliance was <50% at universal vaccine cost ≤$100 and efficacy 75%. Annual vaccine was highly cost-effective with ICER range between $1.05/QALY to $5.11/QALY. Some simulations yielded annual vaccine to be the dominant strategy when universal vaccine efficacy was ≤50%. When increasing the cost to ≤$200, universal vaccine only remained slightly more cost-effective compared to annual vaccine at a high universal vaccine efficacy and annual compliance ≤50% (ICER $1.12-$1.17/QALY). Universal vaccine for 10 years effectiveness was more cost-effective compared to 5 years effectiveness.

Conclusions:  The use of an influenza vaccine may provide great benefits by reducing influenza infection, hospital stay, and mortality among high risk group. A universal vaccine may provide even greater economic value in the pediatric and healthy adult populations. Such vaccine may help guide investment and development for policy makers, manufacturers, insurance companies, investors, scientists, and other decision makers.