Economic evaluation of high-dose inactivated influenza vaccine in adults aged ≥65 years: A systematic literature review

• Published in: Vaccine 2021-03, Vol.39, p.A42-A50
• Main Authors: Colrat, Florian, Thommes, Edward, Largeron, Nathalie, Alvarez, Fabián P.
• Format: Article
• Language: English
• Subjects: Adults; Confidence intervals; Cost analysis; Cost control; Cost-effectiveness; Credibility; Data links; Deactivation; Drug dosages; Economic analysis; Economics; Expenditures; Health economics; High-dose influenza vaccine; Hospitalization; Influenza; Literature reviews; Medical research; Medicare; Older people; Quality assessment; Quality of life; Quality standards; Resource utilization; Systematic review; Vaccines
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2020.12.036

•A high-dose trivalent influenza vaccine (IV3-HD) is available for adults aged ≥65.•We systematically reviewed economic studies of IIV3-HD published up to June 2019.•Seven studies were selected, all performed in the US or Canada.•In all, IIV3-HD was cost-effective or cost-saving versus standard-dose vaccine.•IIV3-HD was also more cost-effective than other available vaccination options. Due to waning immunity, adults aged ≥65 years are at increased risk of seasonal influenza infection and its complications. Adding to this risk, older adults have reduced responses to influenza vaccines. A high-dose trivalent inactivated influenza vaccine (Fluzone High-Dose, Sanofi Pasteur) (IIV3-HD) was developed to improve protection against influenza in adults aged ≥65 years and has been licensed in the US since 2009 and in Canada since 2015. Post-licensure studies have shown that IIV3-HD is more effective than standard–dose trivalent inactivated influenza vaccine (IIV3-SD) at protecting against influenza infection in this population. Here, we performed a systematic review of economic analyses of IIV3-HD in adults aged ≥65 years. On June 9, 2019, using the Ovid search platform, we searched Econlit, Embase, and Ovid MEDLINE® for original studies published in peer-reviewed journals examining the economics or cost-effectiveness of IIV3-HD in adults aged ≥65 years. Two reviewers independently selected studies and assessed their quality. Seven studies were selected, all performed in the US or Canada. Five studies were funded by IIV3-HD manufacturer, and the remaining two by the US National Institute of General Medical Sciences. In all studies, IIV3–HD reduces healthcare resource utilization and is cost-effective or cost-saving compared to IIV3-SD. The main driver is reduced hospitalizations for cardiorespiratory events. IIV3-HD is cost-saving or cost-effective versus IIV3-SD in adults aged ≥65 years. Reduced cardiorespiratory complications are an important driver of these economic benefits. A video summary of the article can be accessed via the Supplementary data link at the end of this article.