Data/hora: 05/06/2024 16:35:15

Provedor de dados: | 55
País: | Brazil
Título: | Cost-utility of quadrivalent versus trivalent influenza vaccine in Brazil – comparison of outcomes from different static model types
Autores: | Van Bellinghen,Laure-Anne; Marijam,Alen; de Araujo,Gabriela Tannus Branco; Gomez,Jorge; Van Vlaenderen,Ilse.
Data: | 2018-01-01
Ano: | 2018
Palavras-chave: | Influenza; Brazil; Cost-effectiveness; Vaccination; QIV; TIV.
Resumo: | ABSTRACT  Background: Influenza burden in Brazil is considerable with 4.2–6.4 million cases in 2008 and influenza-like-illness responsible for 16.9% of hospitalizations. Cost-effectiveness of influenza vaccination may be assessed by different types of models, with limitations due to data availability, assumptions, and modelling approach.  Objective: To understand the impact of model complexity, the cost-utility of quadrivalent versus trivalent influenza vaccines in Brazil was estimated using three distinct models: a 1-year decision tree population model with three age groups (FLOU); a more detailed 1-year population model with five age groups (FLORA); and a more complex lifetime multi-cohort Markov model with nine age groups (FLORENCE).  Methods: Analysis 1 (impact of model structure) compared each model using the same data inputs (i.e., best available data for FLOU). Analysis 2 (impact of increasing granularity) compared each model populated with the best available data for that model.  Results: Using the best data for each model, the discounted cost-utility ratio of quadrivalent versus trivalent influenza vaccine was R$20,428 with FLOU, R$22,768 with FLORA (versus R$20,428 in Analysis 1), and, R$19,257 with FLORENCE (versus R$22,490 in Analysis 1) using a lifetime horizon. Conceptual differences between FLORA and FLORENCE meant the same assumption regarding increased all-cause mortality in at-risk individuals had an opposite effect on the incremental cost-effectiveness ratio in Analysis 2 versus 1, and a proportionally higher number of vaccinated elderly in FLORENCE reduced this ratio in Analysis 2.  Discussion: FLOU provided adequate cost-effectiveness estimates with data in broad age groups. FLORA increased insights (e.g., in healthy versus at-risk, paediatric, respiratory/non-respiratory complications). FLORENCE provided greater insights and precision (e.g., in elderly, costs and complications, lifetime cost-effectiveness).  Conclusion: All three models predicted a cost per quality-adjusted life year gained for quadrivalent versus trivalent influenza vaccine in the range of R$19,257 (FLORENCE) to R$22,768 (FLORA) with the best available data in Brazil (Appendix A).
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702018000100001
Editor: | Brazilian Society of Infectious Diseases
Relação: | 10.1016/j.bjid.2017.11.004
Formato: | text/html
Fonte: | Brazilian Journal of Infectious Diseases  v.22 n.1 2018
Fonte: | info:eu-repo/semantics/openAccess