Registro completo |
Provedor de dados: |
BJID
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País: |
Brazil
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Título: |
Cost-utility of quadrivalent versus trivalent influenza vaccine in Brazil – comparison of outcomes from different static model types
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Autores: |
Van Bellinghen,Laure-Anne
Marijam,Alen
de Araujo,Gabriela Tannus Branco
Gomez,Jorge
Van Vlaenderen,Ilse
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Data: |
2018-01-01
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Ano: |
2018
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Palavras-chave: |
Influenza
Brazil
Cost-effectiveness
Vaccination
QIV
TIV
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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).
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Tipo: |
Info:eu-repo/semantics/article
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Idioma: |
Inglês
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Identificador: |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702018000100001
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Editor: |
Brazilian Society of Infectious Diseases
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Relação: |
10.1016/j.bjid.2017.11.004
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Formato: |
text/html
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Fonte: |
Brazilian Journal of Infectious Diseases v.22 n.1 2018
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Direitos: |
info:eu-repo/semantics/openAccess
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