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Review

Real-World Evidence in Cost-Effectiveness Analysis of Enhanced Influenza Vaccines in Adults ≥ 65 Years of Age: Literature Review and Expert Opinion

by
Maarten Postma
1,2,3,
David Fisman
4,
Norberto Giglio
5,
Sergio Márquez-Peláez
6,
Van Hung Nguyen
7,
Andrea Pugliese
8,
Jesús Ruiz-Aragón
9,
Analia Urueña
10 and
Joaquin Mould-Quevedo
11,*
1
Department of Health Sciences, University Medical Center Groningen, University of Groningen, P.O. Box 72, 9700 AB Groningen, The Netherlands
2
Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, 9713 AB Groningen, The Netherlands
3
Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, 40132 Bandung, Indonesia
4
Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada
5
Hospital de Niños Ricardo Gutièrrez, Buenos Aires 1425, Argentina
6
Department of Economics, Economic Analysis, Faculty of Business Pablo de Olavide University, 41013 Seville, Spain
7
VNH Consulting, Montreal, QC H2V 3L8, Canada
8
Department of Mathematics, University of Trento, 38123 Trento, Italy
9
Hospital de la Línea de la Concepción, 11300 Cádiz, Spain
10
Centro de Estudios para la Prevención y Control de Enfermedades Transmisibles, Universidad Isalud, Buenos Aires C1095AAS, Argentina
11
CSL Seqirus Inc., Summit, NJ 07901, USA
 
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Author to whom correspondence should be addressed.
Vaccines 2023, 11(6), 1089; https://doi.org/10.3390/vaccines11061089
Submission received: 9 May 2023 / Revised: 30 May 2023 / Accepted: 1 June 2023 / Published: 11 June 2023
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Abstract

Influenza vaccination can benefit most populations, including adults ≥ 65 years of age, who are at greater risk of influenza-related complications. In many countries, enhanced vaccines, such as adjuvanted, high-dose, and recombinant trivalent/quadrivalent influenza vaccines (aTIV/aQIV, HD-TIV/HD-QIV, and QIVr, respectively), are recommended in older populations to provide higher immunogenicity and increased relative vaccine efficacy/effectiveness (rVE) than standard-dose vaccines. This review explores how efficacy and effectiveness data from randomized controlled trials and real-world evidence (RWE) are used in economic evaluations. Findings from published cost-effectiveness analyses (CEA) on enhanced influenza vaccines for older adults are summarized, and the assumptions and approaches used in these CEA are assessed alongside discussion of the importance of RWE in CEA. Results from many CEA showed that adjuvanted and high-dose enhanced vaccines were cost-effective compared with standard vaccines, and that differences in rVE estimates and acquisition price may drive differences in cost-effectiveness estimates between enhanced vaccines. Overall, RWE and CEA provide clinical and economic rationale for enhanced vaccine use in people ≥ 65 years of age, an at-risk population with substantial burden of disease. Countries that consider RWE when making vaccine recommendations have preferentially recommended aTIV/aQIV, as well as HD-TIV/HD-QIV and QIVr, to protect older individuals.
Keywords: influenza; enhanced vaccine; adjuvanted; cost-effectiveness analysis influenza; enhanced vaccine; adjuvanted; cost-effectiveness analysis

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MDPI and ACS Style

Postma, M.; Fisman, D.; Giglio, N.; Márquez-Peláez, S.; Nguyen, V.H.; Pugliese, A.; Ruiz-Aragón, J.; Urueña, A.; Mould-Quevedo, J. Real-World Evidence in Cost-Effectiveness Analysis of Enhanced Influenza Vaccines in Adults ≥ 65 Years of Age: Literature Review and Expert Opinion. Vaccines 2023, 11, 1089. https://doi.org/10.3390/vaccines11061089

AMA Style

Postma M, Fisman D, Giglio N, Márquez-Peláez S, Nguyen VH, Pugliese A, Ruiz-Aragón J, Urueña A, Mould-Quevedo J. Real-World Evidence in Cost-Effectiveness Analysis of Enhanced Influenza Vaccines in Adults ≥ 65 Years of Age: Literature Review and Expert Opinion. Vaccines. 2023; 11(6):1089. https://doi.org/10.3390/vaccines11061089

Chicago/Turabian Style

Postma, Maarten, David Fisman, Norberto Giglio, Sergio Márquez-Peláez, Van Hung Nguyen, Andrea Pugliese, Jesús Ruiz-Aragón, Analia Urueña, and Joaquin Mould-Quevedo. 2023. "Real-World Evidence in Cost-Effectiveness Analysis of Enhanced Influenza Vaccines in Adults ≥ 65 Years of Age: Literature Review and Expert Opinion" Vaccines 11, no. 6: 1089. https://doi.org/10.3390/vaccines11061089

APA Style

Postma, M., Fisman, D., Giglio, N., Márquez-Peláez, S., Nguyen, V. H., Pugliese, A., Ruiz-Aragón, J., Urueña, A., & Mould-Quevedo, J. (2023). Real-World Evidence in Cost-Effectiveness Analysis of Enhanced Influenza Vaccines in Adults ≥ 65 Years of Age: Literature Review and Expert Opinion. Vaccines, 11(6), 1089. https://doi.org/10.3390/vaccines11061089

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