A systematic review of the health economic consequences of quadrivalent influenza vaccination

ABSTRACT

Background: Quadrivalent influenza vaccines (QIVs) contain antigens derived from an additional influenza type B virus as compared with currently used trivalent influenza vaccines (TIVs). This should overcome a potential reduced vaccine protection due to mismatches between TIV and circulating B viruses. In this study, we systematically reviewed the available literature on health economic evaluations of switching from TIV to QIV.

Areas covered: The databases of Medline and Embase were searched systematically to identify health economic evaluations of QIV versus TIV published before September 2016.A total of sixteen studies were included, thirteen cost-effectiveness analyses and three cost-comparisons.

Expert commentary: Published evidence on the cost-effectiveness of QIV suggests that switching from TIV to QIV would be a valuable intervention from both the public health and economic viewpoint. However, more research seems mandatory. Our main recommendations for future research include: 1) more extensive use of dynamic models in order to estimate the full impact of QIV on influenza transmission including indirect effects, 2) improved availability of data on disease outcomes and costs related to influenza type B viruses, and 3) more research on immunogenicity of natural influenza infection and vaccination, with emphasis on cross-reactivity between different influenza B viruses and duration of protection.

KEYWORDS:

• Economic evaluation
• cost-effectiveness
• influenza
• vaccination
• quadrivalent
• vaccine
• model

Declaration of interest

The appointments of PT de Boer and FCK Dolk are partly supported by grants of different pharmaceutical companies, including companies involved in the subject matter of this study. BM van Maanen and B Ultsch report no conflicts of interest. O Damm conducted studies for pharmaceutical companies, including companies involved in the subject matter of this study. P Crépey, R Pitman, JC Wilschut and MJ Postma have received grants and honoraria from pharmaceutical companies, including companies involved in the subject matter of this study. 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 materials discussed in the manuscript apart from those disclosed.

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Funding

This paper was not funded.