Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysis
Summary: Background: A number of cost-effectiveness analysis of influenza vaccination have been conducted to estimate value of influenza vaccines in elderly and health workers (HWs). This study aims to summarize cost-effectiveness evidence by pooling the incremental net monetary benefit (INMB) of i...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-05-01
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| Series: | EClinicalMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537022001407 |
| _version_ | 1828343391195234304 |
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| author | Piyameth Dilokthornsakul Le My Lan Ammarin Thakkinstian Raymond Hutubessy Philipp Lambach Nathorn Chaiyakunapruk |
| author_facet | Piyameth Dilokthornsakul Le My Lan Ammarin Thakkinstian Raymond Hutubessy Philipp Lambach Nathorn Chaiyakunapruk |
| author_sort | Piyameth Dilokthornsakul |
| collection | DOAJ |
| description | Summary: Background: A number of cost-effectiveness analysis of influenza vaccination have been conducted to estimate value of influenza vaccines in elderly and health workers (HWs). This study aims to summarize cost-effectiveness evidence by pooling the incremental net monetary benefit (INMB) of influenza vaccination. Methods: A systematic review was performed in electronic databases from their inceptions to February 2022. Cost-effectiveness studies reporting quality-adjusted life year (QALY), or life year (LY) of influenza vaccination were included. Stratified meta-analyses by population, perspective, country income-level, and herd-effect were performed to pool INMB across studies. The protocol was registered at PROSPERO (CRD42021246746). Findings: A total of 21 studies were included. Eighteen studies were conducted in elderly, two studies were conducted in HWs, and one study was conducted in both elderly and HWs. According to pre-specified analyses, studies for elderly in high-income economies (countries) (HIEs) and upper-middle income economies (UMIEs) without herd effect could be pooled. For HIEs under a societal perspective, the perspective which identify all relevant costs occurred in the society including direct medical cost, direct non-medical cost and indirect cost, pooled INMB was $217·38 (206·23, 228·53, I2 =28.2%), while that for healthcare provider/payer perspective was $0·20 (-11,908·67, 11,909·07, I2 = 0.0%). For societal perspective in UMIEs, pooled INMB was $28·39 (-190·65, 133·87, I2 = 92.8%). The findings were robust across a series of sensitivity analyses for HIEs. Studies in HWs indicated that influenza vaccination was cost-effective compared to no vaccination or current practice. Interpretation: Influenza vaccination might be cost-effective for HWs and elderly in HIEs under a societal perspective with relatively small variations among included studies, while there remains limited evidence for healthcare provider/payer perspective or other level of incomes. Further evidence is warranted. Funding: This study was funded by a grant of Immunization, Vaccine and Biologicals department of the World Health Organization. The authors would like to acknowledge the contributions of the US CDC which provided financial support to the development and publication of this report. Grant number US CDC, WHO IVR (U50CK000431). |
| first_indexed | 2024-04-13T23:42:29Z |
| format | Article |
| id | doaj.art-494c94a229ce47a9a78c707801051202 |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-13T23:42:29Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-494c94a229ce47a9a78c7078010512022022-12-22T02:24:27ZengElsevierEClinicalMedicine2589-53702022-05-0147101410Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysisPiyameth Dilokthornsakul0Le My Lan1Ammarin Thakkinstian2Raymond Hutubessy3Philipp Lambach4Nathorn Chaiyakunapruk5Center for Medical and Health Technology Assessment (CM-HTA), Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand; Center of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, ThailandDepartment of Pharmacotherapy, University of Utah, Salt Lake City, UT, United StatesDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, SwitzerlandDepartment of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland; Corresponding author: Department of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, Switzerland.Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, United States; IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, United States; Corresponding author: Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, United States.Summary: Background: A number of cost-effectiveness analysis of influenza vaccination have been conducted to estimate value of influenza vaccines in elderly and health workers (HWs). This study aims to summarize cost-effectiveness evidence by pooling the incremental net monetary benefit (INMB) of influenza vaccination. Methods: A systematic review was performed in electronic databases from their inceptions to February 2022. Cost-effectiveness studies reporting quality-adjusted life year (QALY), or life year (LY) of influenza vaccination were included. Stratified meta-analyses by population, perspective, country income-level, and herd-effect were performed to pool INMB across studies. The protocol was registered at PROSPERO (CRD42021246746). Findings: A total of 21 studies were included. Eighteen studies were conducted in elderly, two studies were conducted in HWs, and one study was conducted in both elderly and HWs. According to pre-specified analyses, studies for elderly in high-income economies (countries) (HIEs) and upper-middle income economies (UMIEs) without herd effect could be pooled. For HIEs under a societal perspective, the perspective which identify all relevant costs occurred in the society including direct medical cost, direct non-medical cost and indirect cost, pooled INMB was $217·38 (206·23, 228·53, I2 =28.2%), while that for healthcare provider/payer perspective was $0·20 (-11,908·67, 11,909·07, I2 = 0.0%). For societal perspective in UMIEs, pooled INMB was $28·39 (-190·65, 133·87, I2 = 92.8%). The findings were robust across a series of sensitivity analyses for HIEs. Studies in HWs indicated that influenza vaccination was cost-effective compared to no vaccination or current practice. Interpretation: Influenza vaccination might be cost-effective for HWs and elderly in HIEs under a societal perspective with relatively small variations among included studies, while there remains limited evidence for healthcare provider/payer perspective or other level of incomes. Further evidence is warranted. Funding: This study was funded by a grant of Immunization, Vaccine and Biologicals department of the World Health Organization. The authors would like to acknowledge the contributions of the US CDC which provided financial support to the development and publication of this report. Grant number US CDC, WHO IVR (U50CK000431).http://www.sciencedirect.com/science/article/pii/S2589537022001407Influenza vaccinationCost-effectivenessEconomic evaluationSystematic review, Meta-analysis |
| spellingShingle | Piyameth Dilokthornsakul Le My Lan Ammarin Thakkinstian Raymond Hutubessy Philipp Lambach Nathorn Chaiyakunapruk Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysis EClinicalMedicine Influenza vaccination Cost-effectiveness Economic evaluation Systematic review, Meta-analysis |
| title | Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysis |
| title_full | Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysis |
| title_fullStr | Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysis |
| title_full_unstemmed | Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysis |
| title_short | Economic evaluation of seasonal influenza vaccination in elderly and health workers: A systematic review and meta-analysis |
| title_sort | economic evaluation of seasonal influenza vaccination in elderly and health workers a systematic review and meta analysis |
| topic | Influenza vaccination Cost-effectiveness Economic evaluation Systematic review, Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2589537022001407 |
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