Modelling the population-level benefits and cost-effectiveness of cell-based quadrivalent influenza vaccine for children and adolescents aged 6 months to 17 years in the US

ABSTRACT

Background

Cell-based quadrivalent influenza vaccines (QIVc) can increase effectiveness against seasonal influenza by avoiding mismatch from egg adaption of vaccine viruses. This study evaluates the population-level cost-effectiveness and impacts on health outcomes of QIVc versus an egg-based vaccine (QIVe) in children aged 6 months to 17 years in the US.

Research Design and Methods

A dynamic age-structured susceptible-exposed-infected-recovered model was used to simulate influenza transmission in low and high incidence seasons for two scenarios: 1. QIVe for 6 months–17 year-olds, QIVc for 18–64 year-olds, and adjuvanted QIV (aQIV) for ≥ 65 year-olds, and 2. QIVc for 6 months–64 year-olds, and aQIV for ≥ 65 year-olds. Probabilistic sensitivity analysis was performed to account for uncertainty in parameter estimates. Cost-effectiveness was evaluated as incremental cost-effectiveness ratios (ICERs).

Results

Extension of QIVc to children resulted in 3–4% reductions in cases (1,656,271), hospitalizations (16,688), and deaths (2,126) at a population level in a high incidence season, and 65% reductions (cases: 2,856,384; hospitalizations: 31667; deaths: 4,163) in a low incidence season. Use of QIVc would be cost-saving, with ICERs of -$16,427/QALY and -$8,100/QALY from a payer perspective and -$22,669/QALY and -$15,015/QALY from a societal perspective, for low and high incidence seasons respectively. Cost savings were estimated at approximately $468 million and $1.366 billion for high and low incidence seasons, respectively.

Conclusion

Use of QIVc instead of QIVe in children > 6 months of age in the US would reduce the disease burden and be cost-saving from both a payer and societal perspective.

KEYWORDS:

• influenza vaccine
• cost-effectiveness
• children
• cell-based vaccines
• vaccine effectiveness

Declaration of interest

VH Nguyen and SI Pelton’s work for this study was funded by Seqirus U.S.A. Inc. J F Mould-Quevedo is an employee of Seqirus U.S.A. Inc., and a CSL shareholder. Seqirus has manufactured and marketed QIVc since the 2017–2018 influenza season. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or material discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors substantially contributed to the conceptualization, methodology, and analysis of the study, together with the design, review and revision of the manuscript. Modelling was performed by Van Hung Nguyen.

Previous conference presentation

The data from in this manuscript have been previously presented at ID Week 2023: Mould-Quevedo, J.; Nguyen, V.H. The Value of the Influenza Cell-Based Vaccine in the Pediatric Population. A Dynamic Transmission Modelling Approach in the U.S. In Proceedings of the ID Week 2023, Boston, MA, U.S.A., 11–15 October 2023.

Acknowledgments

The authors would like to thank Dr J Engelmoer (Sula Communications BV, Utrecht, The Netherlands) for editorial assistance in preparation of this manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14760584.2023.2295014

Additional information

Funding

This manuscript was funded by CSL Seqirus Inc.