Despite recent reports that the intranasal live attenuated influenza vaccine might cause more adverse events in young children than does the inactivated influenza vaccine, the cost-effectiveness of the two approaches remains comparable, according to a study published online Oct. 4 in the Archives of Pediatric and Adolescent Medicine.
Louise A. Koenig
The cost-effectiveness of the intranasal live attenuated influenza vaccine is comparable to inactivated influenza vaccine, despite hypotheses otherwise, researchers say.
In a mathematical simulation model, both the live attenuated vaccine and the inactivated vaccine yielded similar cost-effectiveness ratios of less than $40,000 per quality-adjusted life year (QALY) among children under 5 years, which compares well with other well-accepted pediatric interventions, said Lisa A. Prosser, Ph.D., of the University of Michigan Health System, Ann Arbor, and her associates.
The investigators assessed the cost-effectiveness of each of the vaccines and of no vaccination using a mathematical simulation model that estimated the effects on influenza-related health outcomes in a hypothetical cohort of healthy children aged 6 months to 4 years. They had previously reported that the same model showed comparable cost-effectiveness between the two vaccine strategies in 2006. They now report their results using the same simulation program but incorporating more recent epidemiologic data on adverse events such as wheezing and fever and on the costs of influenza-related hospitalizations.
In this low-risk hypothetical population, under a wide range of assumptions, the live attenuated vaccine was projected to avert more episodes of influenza, influenza-related hospitalizations, and deaths than was the inactivated vaccine. However, this benefit was somewhat counterbalanced by increase in adverse events with the live attenuated vaccine.
Nevertheless, either vaccine strategy yielded a net health benefit, compared with no vaccination, as measured by quality of life-years gained, Dr. Prosser and her colleagues said (Arch. Pediatr. Adolesc. Med. 2010 [doi:10.1001/archpediatrics.2010.182]).
Under different conditions, the model showed that cost-effectiveness ratios ranged from $20,000/QALY to $33,000/QALY with the live attenuated vaccine. Similarly, cost-effectiveness ratios ranged from $21,000/QALY to $37,000/QALY with the inactivated vaccine.
“One potential limitation of this analysis is the exclusion of herd immunity effects. If these effects were considered, they would likely result in more favorable cost-effectiveness ratios for [both] vaccination options,” the investigators added.
Disclosures: This study was funded by the Centers for Disease Control and Prevention through the Harvard/CDC Joint Initiative in Vaccine Economics. No financial conflicts of interest were reported.