Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.jval.2019.07.001
Title: Cost-Effectiveness Analysis for Influenza Vaccination Coverage and Timing in Tropical and Subtropical Climate Settings: A Modeling Study
Authors: Yue, Mu
Dickens, Borame L 
Yoong, Joanne Su-yin
Chen, Mark I-Cheng 
Teerawattananon, Yot 
Cook, Alex R 
Keywords: Social Sciences
Science & Technology
Life Sciences & Biomedicine
Economics
Health Care Sciences & Services
Health Policy & Services
Business & Economics
elderly
influenza
seasonal
tropics
vaccine
SEASONAL INFLUENZA
VIRUS INFECTION
OLDER-ADULTS
HONG-KONG
STRATEGIES
MORTALITY
RESPONSES
EFFICACY
VACCINES
Issue Date: Dec-2019
Publisher: ELSEVIER SCIENCE INC
Citation: Yue, Mu, Dickens, Borame L, Yoong, Joanne Su-yin, Chen, Mark I-Cheng, Teerawattananon, Yot, Cook, Alex R (2019-12). Cost-Effectiveness Analysis for Influenza Vaccination Coverage and Timing in Tropical and Subtropical Climate Settings: A Modeling Study. VALUE IN HEALTH 22 (12) : 1345-1354. ScholarBank@NUS Repository. https://doi.org/10.1016/j.jval.2019.07.001
Abstract: Background: The lack of seasonality in influenza epidemics in the tropics makes the application of well-established temperate zone national vaccination plans challenging. Objectives: We developed an individual-based simulation model to study optimal vaccination scheduling and assess cost-effectiveness of these vaccination schedules in scenarios of no influenza seasonality and the seasonality regimes of Singapore, Taipei, and Tokyo. Methods: The simulation models heterogeneities in human contact networks, levels of protective antibodies following infection, the effectiveness of the influenza vaccine, and seasonality. Using a no intervention baseline, we consider 3 alternative vaccination strategies: (1) annual vaccination for a percentage of the elderly, (2) biannual vaccination for a percentage of the elderly, and (3) annual vaccination for all elderly and a fraction of the remaining population. We considered 5 vaccination uptake rates for each strategy and modeled the estimated costs, quality-adjusted life years, and incremental cost-effectiveness ratios (ICERs), indicating the cost-effectiveness of each scenario. Results: In Singapore, annual vaccination for a proportion of elderly is largely cost-effective. However, with fixed uptake rates, partial biannual vaccination for the elderly yields a higher ICER than partial annual vaccination for the elderly, resulting in a cost-ineffective ICER. The most optimal strategy is the total vaccination of all the elderly and a proportion of individuals from other age groups, which results in a cost-saving ICER. This finding is consistent across different seasonality regimes. Conclusions: Tropical countries like Singapore can have comparably cost-effective vaccination strategies as found in countries with winter epidemics. The vaccination of all the elderly and a proportion of other age groups is the most cost-effective strategy, supporting the need for an extensive national influenza vaccination program.
Source Title: VALUE IN HEALTH
URI: https://scholarbank.nus.edu.sg/handle/10635/242808
ISSN: 1098-3015
1524-4733
DOI: 10.1016/j.jval.2019.07.001
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