The potential cost-effectiveness of next generation influenza vaccines in England and Wales: a modelling analysis

Waterlow, N. R., Procter, S. R., van Leeuwen, E., Radhakrishnan, S. , Jit, M. and Eggo, R. M. (2023) The potential cost-effectiveness of next generation influenza vaccines in England and Wales: a modelling analysis. Vaccine, 41(41), pp. 6017-6024. (doi: 10.1016/j.vaccine.2023.08.031) (PMID:37633749)

Abstract

Next generation influenza vaccines are in development and have the potential for widespread health and economic benefits. Determining the potential health and economic impact for these vaccines is needed to drive investment in bringing these vaccines to the market, and to inform which groups public health policies on influenza vaccination should target. We used a mathematical modelling approach to estimate the epidemiological impact and cost-effectiveness of next generation influenza vaccines in England and Wales. We used data from an existing fitted model, and evaluated new vaccines with different characteristics ranging from improved vaccines with increased efficacy duration and breadth of protection, to universal vaccines, defined in line with the World Health Organisation (WHO) Preferred Product Characteristics (PPC). We calculated the cost effectiveness of new vaccines in comparison to the current seasonal vaccination programme. We calculated and compared the Incremental Cost-Effectiveness Ratio and Incremental Net Monetary Benefit for each new vaccine type. All analysis was conducted in R. We show that next generation influenza vaccines may result in a 21% to 77% reduction in influenza infections, dependent on vaccine characteristics. Our economic modelling shows that using any of these next generation vaccines at 2019 coverage levels would be highly cost-effective at a willingness to pay threshold of £20,000 for a range of vaccine prices. The vaccine threshold price for the best next generation vaccines in £-2019 is £230 (95%CrI £192 - £269) per dose, but even minimally-improved influenza vaccines could be priced at £18 (95%CrI £16 - £21) per dose and still remain cost-effective. This evaluation demonstrates the promise of next generation influenza vaccines for impact on influenza epidemics, and likely cost-effectiveness profiles. We have provided evidence towards a full value of vaccines assessment which bolsters the investment case for development and roll-out of next-generation influenza vaccines.

• Item Type: Articles
• Additional Information: Funding: NRW, SR, SP and RME were funded through the Task Force for Global Health in collaboration with Partnership for Influenza Vaccine Introduction (PIVI), Ready2Respond, Wellcome Trust and Centers for Disease Control and Prevention (CDC). EvL and RME were also supported by the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Modelling and Health Economics, a partnership between UK HSA, Imperial College London, and LSHTM (grant number NIHR200908) and EvL was also supported by the European Union's Horizon 2020 research and innovation programme - project EpiPose (101003688).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Radhakrishnan, Dr Sree
• Authors: Waterlow, N. R., Procter, S. R., van Leeuwen, E., Radhakrishnan, S., Jit, M., and Eggo, R. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
• Journal Name: Vaccine
• Publisher: Elsevier
• ISSN: 0264-410X
• ISSN (Online): 1873-2518
• Published Online: 24 August 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Vaccine 41(41):6017-6024
• Publisher Policy: Reproduced under a Creative Commons license