Ocena opłacalności kosztowej adjuwantowej szczepionki przeciw grypie w populacji osób starszych w Holandii

In the Netherlands, older adults are vaccinated with the standard (dose) influenza vaccine (sIV). Enhanced vaccines, such as the adjuvanted influenza vaccine (aIV) and high-dose (HD-IV) influenza vaccine, have demonstrated clinical and economic benefits. This analysis aimed to evaluate the cost-effectiveness of replacing sIV by aIV in adults aged 60y and older and in high‑risk adults aged 50-59y in the Netherlands. A static decision-tree model was adapted to the Dutch setting to assess the associated costs and health outcomes. The model simulated a historic single average influenza season during 2013-2020 from a societal perspective. Influenza-specific data were used to estimate symptomatic incidence, general practitioner (GP) visits, hospitalizations and excess mortality. Recent publications on aIV's effectiveness that met the inclusion criteria provided a set of non-randomized real-world data. These studies provided a relative vaccine effectiveness (rVE) range that approximated the 10-30% rVE reported by the Dutch Health Council in a recent assessment; this range was analyzed in the economic model. Sensitivity analyses assessed uncertainty, including varying the rVE over a broader range. Applying an rVE range of 10-30%, ~1,571-4,713 GP visits, 498-1,494 hospitalizations, and 347-1,041 deaths could have been avoided. These health benefits translated into €4.3-12.8 million cost savings and 2,220-6,659 quality-adjusted life years (QALYs) gained. The incremental cost-effectiveness ratio (ICER) was estimated at €2,144-11,903/QALY. Based on economic modeling, replacing sIV with aIV is suggested to be a cost-effective strategy, with ICERs below the commonly accepted willingness-to-pay threshold of €50,000/QALY gained.