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Article: Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis

TitleCost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis
Authors
KeywordsInfluenza
Older adults
Vaccination
China
Cost-effectiveness analysis
Issue Date2020
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmed/
Citation
BMC Medicine, 2020, v. 18, p. article no. 90 How to Cite?
AbstractBackground: China has an aging population with an increasing number of adults aged ≥ 60 years. Influenza causes a heavy disease burden in older adults, but can be alleviated by vaccination. We assessed the cost-effectiveness of a potential government-funded seasonal influenza vaccination program in older adults in China. Methods: We characterized the health and economic impact of a fully funded influenza vaccination program for older adults using China-specific influenza disease burden, and related cost data, etc. Using a decision tree model, we calculated the incremental costs per quality-adjusted life year (QALY) gained of vaccination from the societal perspective, at a willingness-to-pay threshold equivalent to GDP per capita (US$8840). Moreover, we estimated the threshold vaccination costs, under which the fully funded vaccination program is cost-effective using GDP per capita as the willingness-to-pay threshold. Results: Compared to current self-paid vaccination, a fully funded vaccination program is expected to prevent 19,812 (95% uncertainty interval, 7150–35,783) influenza-like-illness outpatient consultations per year, 9418 (3386–17,068) severe acute respiratory infection hospitalizations per year, and 8800 (5300–11,667) respiratory excess deaths due to influenza per year, and gain 70,212 (42,106–93,635) QALYs per year. Nationally, the incremental costs per QALY gained of the vaccination program is US$4832 (3460–8307), with a 98% probability of being cost-effective. The threshold vaccination cost is US$10.19 (6.08–13.65). However, variations exist between geographical regions, with Northeast and Central China having lower probabilities of cost-effectiveness. Conclusions: Our results support the implementation of a government fully funded older adult vaccination program in China. The regional analysis provides results across settings that may be relevant to other countries with similar disease burden and economic status, especially for low- and middle-income countries where such analysis is limited.
Persistent Identifierhttp://hdl.handle.net/10722/282186
ISSN
2019 Impact Factor: 6.782
2015 SCImago Journal Rankings: 3.415
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYang, J-
dc.contributor.authorAtkins, KE-
dc.contributor.authorFeng, L-Z-
dc.contributor.authorBaguelin, M-
dc.contributor.authorWu, P-
dc.contributor.authorYan, H-
dc.contributor.authorLau, EHY-
dc.contributor.authorWu, JT-
dc.contributor.authorLiu, Y-
dc.contributor.authorCowling, BJ-
dc.contributor.authorJit, M-
dc.contributor.authorYu, H-
dc.date.accessioned2020-05-05T14:31:52Z-
dc.date.available2020-05-05T14:31:52Z-
dc.date.issued2020-
dc.identifier.citationBMC Medicine, 2020, v. 18, p. article no. 90-
dc.identifier.issn1741-7015-
dc.identifier.urihttp://hdl.handle.net/10722/282186-
dc.description.abstractBackground: China has an aging population with an increasing number of adults aged ≥ 60 years. Influenza causes a heavy disease burden in older adults, but can be alleviated by vaccination. We assessed the cost-effectiveness of a potential government-funded seasonal influenza vaccination program in older adults in China. Methods: We characterized the health and economic impact of a fully funded influenza vaccination program for older adults using China-specific influenza disease burden, and related cost data, etc. Using a decision tree model, we calculated the incremental costs per quality-adjusted life year (QALY) gained of vaccination from the societal perspective, at a willingness-to-pay threshold equivalent to GDP per capita (US$8840). Moreover, we estimated the threshold vaccination costs, under which the fully funded vaccination program is cost-effective using GDP per capita as the willingness-to-pay threshold. Results: Compared to current self-paid vaccination, a fully funded vaccination program is expected to prevent 19,812 (95% uncertainty interval, 7150–35,783) influenza-like-illness outpatient consultations per year, 9418 (3386–17,068) severe acute respiratory infection hospitalizations per year, and 8800 (5300–11,667) respiratory excess deaths due to influenza per year, and gain 70,212 (42,106–93,635) QALYs per year. Nationally, the incremental costs per QALY gained of the vaccination program is US$4832 (3460–8307), with a 98% probability of being cost-effective. The threshold vaccination cost is US$10.19 (6.08–13.65). However, variations exist between geographical regions, with Northeast and Central China having lower probabilities of cost-effectiveness. Conclusions: Our results support the implementation of a government fully funded older adult vaccination program in China. The regional analysis provides results across settings that may be relevant to other countries with similar disease burden and economic status, especially for low- and middle-income countries where such analysis is limited.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmed/-
dc.relation.ispartofBMC Medicine-
dc.rightsBMC Medicine. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectInfluenza-
dc.subjectOlder adults-
dc.subjectVaccination-
dc.subjectChina-
dc.subjectCost-effectiveness analysis-
dc.titleCost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis-
dc.typeArticle-
dc.identifier.emailWu, P: pengwu@hku.hk-
dc.identifier.emailLau, EHY: ehylau@hku.hk-
dc.identifier.emailWu, JT: joewu@hku.hk-
dc.identifier.emailCowling, BJ: bcowling@hku.hk-
dc.identifier.authorityWu, P=rp02025-
dc.identifier.authorityLau, EHY=rp01349-
dc.identifier.authorityWu, JT=rp00517-
dc.identifier.authorityCowling, BJ=rp01326-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12916-020-01545-6-
dc.identifier.pmid32284056-
dc.identifier.pmcidPMC7155276-
dc.identifier.scopuseid_2-s2.0-85083374028-
dc.identifier.hkuros309811-
dc.identifier.volume18-
dc.identifier.spagearticle no. 90-
dc.identifier.epagearticle no. 90-
dc.identifier.isiWOS:000526851700001-
dc.publisher.placeUnited Kingdom-

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