scholarly journals Economic Assessment of High-Dose Versus Adjuvanted Influenza Vaccine: An Evaluation of Hospitalization Costs Based on a Cohort Study

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1065
Author(s):  
Robertus van Aalst ◽  
Stefan Gravenstein ◽  
Vincent Mor ◽  
Salaheddin M. Mahmud ◽  
Jan Wilschut ◽  
...  
Keyword(s):  
Cohort Study ◽  
Influenza Vaccine ◽  
Economic Assessment ◽  
High Dose ◽  
Hospitalization Rates ◽  
Hospitalization Costs ◽  
Study Population ◽  
The Difference ◽  
Cardiovascular Illness ◽  
The U.S

Two influenza vaccines are licensed in the U.S. exclusively for the 65 years and older population: a trivalent inactivated high-dose influenza vaccine (HD-IIV3) and a trivalent inactivated adjuvanted influenza vaccine (aIIV3). In a recent publication, we estimated a relative vaccine effectiveness (rVE) of HD-IIV3 vs. aIIV3 of 12% (95% CI: 3.3–20%) for influenza-related hospitalizations using a retrospective study design, but did not report the number of prevented hospitalizations nor the associated avoided cost. In this paper we report estimations for both. Methods: Leveraging the rVE of a cohort study over two influenza seasons (2016/17 and 2017/18), we collected cost data for healthcare provided to the same study population. Vaccine costs were obtained from the Medicare pricing schedule. Our economic assessment compared cost of vaccination and hospital care for patients experiencing acute respiratory or cardiovascular illness. Results: We analyzed 1.9 million HD-IIV3 and 223,793 aIIV3 recipients. Average vaccine list prices were $46.23 for HD-IIV3 and $48.26 for aIIV3. The hospitalization rates for respiratory disease in HD-IIV3 and aIIV3 recipients were 187 (95% CI: 185–189) and 212 (195–231) per 10,000 persons-years, respectively. Attributing the average cost per hospitalization of $12,652 ($12,214–$13,090) to the difference in hospitalization rates, we estimate net savings of HD-IIV3 to be $34 ($10–$62) per recipient. Conclusion: Pooled over two predominantly A/H3N2 respiratory seasons, vaccination with HD-IIV3 was associated with lower hospitalization rates and associated costs compared to aIIV3 in senior members of a large national managed health care company in the U.S. Reduced hospitalizations affect healthcare utilization overall, and therefore other costly health outcomes.

scholarly journals 29. Impact of Enhanced Influenza Vaccines on Direct Healthcare Costs for the U.S. Elderly: A Comprehensive Real-World Evaluation of Adjuvanted Trivalent Influenza Vaccine Compared to Trivalent High-Dose Influenza Vaccine for the 2018–19 Influenza Season

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S38-S39
Author(s):  
Maarten Postma ◽  
Stephen I Pelton ◽  
Victoria Divino ◽  
Joaquin F Mould-Quevedo ◽  
Drishti Shah ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Healthcare Costs ◽  
Influenza Season ◽  
Elderly Subjects ◽  
High Dose ◽  
Office Visits ◽  
Research Support ◽  
Physician Office ◽  
Trivalent Influenza Vaccine ◽  
The U.S

Abstract Background Influenza generates a substantial economic burden ($3.2B in the U.S. annually) due to direct medical costs such as physician office visits or hospitalizations, especially among the elderly. Recent published literature for the 2018–19 influenza season has demonstrated similar clinical effectiveness between adjuvanted trivalent influenza vaccine (aTIV) and trivalent high dose influenza vaccine (TIV-HD). This research aimed to assess the annualized mean all-cause and influenza-related healthcare costs among subjects 65+ years vaccinated with aTIV or TIV-HD during the 2018–19 influenza season. Methods A retrospective cohort analysis was conducted using professional fee, prescription claims and hospital charge master data in the U.S. Baseline characteristics included age, gender, payer type, region, Charlson Comorbidity Index, comorbidities, indicators of frail health status, and pre-index hospitalization rates. Treatment selection bias was adjusted through 1:1 propensity score matching (PSM). Economic outcomes included annualized mean all-cause costs and influenza-related costs, which comprised influenza-related hospitalizations, emergency room (ER) visits, and physician office visits costs. Mean costs were compared using paired t-test. Adjusted analyses were conducted using generalized estimating equation (GEE) models, with two-part models for influenza-related costs. With the GEEs, adjustment for outliers (99th percentile) were addressed and predicted healthcare costs were obtained through bootstrapping (500 replications). Results During the 2018–19 influenza season, the PSM sample comprised 561,243 recipients of aTIV and 561,243 recipients of TIV-HD. Following GEE adjustment, predicted mean annualized all-cause and influenza-related costs per patient were statistically similar between aTIV and TIV-HD (US$9,676 vs. US$9,625 and US$23.75 vs. US$21.79, respectively). Both aTIV and TIV-HD were comparable in terms of predicted mean annualized costs for influenza-related hospitalizations (US$20.28 vs. US$18.13) and influenza-related office visits (US$1.29 vs. US$1.34). Conclusion In adjusted analyses, total all-cause and influenza-related healthcare costs were comparable among elderly subjects vaccinated with either aTIV or TIV-HD. Disclosures Maarten Postma, Dr., IQVIA (Consultant) Stephen I. Pelton, MD, Merck vaccine (Consultant, Grant/Research Support)Pfizer (Consultant, Grant/Research Support)Sanofi Pasteur (Consultant, Other Financial or Material Support, DSMB)Seqirus Vaccine Ltd. (Consultant) Victoria Divino, PhD, Seiqrus Vaccines Ltd. (Consultant) Joaquin F. Mould-Quevedo, PhD, Seqirus Vaccines Ltd. (Employee, Shareholder) Drishti Shah, PhD, Seqirus Vaccines Ltd. (Consultant) Mitchell DeKoven, PhD, Seqirus Vaccines Ltd. (Consultant) Girishanthy Krishnarajah, PhD, Seqirus Vaccines Ltd. (Employee, Shareholder)

scholarly journals 14. A Comprehensive Real-World Analysis to Compare Adjuvanted Trivalent Influenza Vaccine and Trivalent High Dose Influenza Vaccine by Age and Period of High Influenza Activity for the 2018–19 Season among U.S. Elderly

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S29-S30
Author(s):  
Maarten Postma ◽  
Stephen I Pelton ◽  
Victoria Divino ◽  
Joaquin F Mould-Quevedo ◽  
Drishti Shah ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Poisson Regression ◽  
Age Groups ◽  
Vaccine Effectiveness ◽  
High Dose ◽  
Office Visits ◽  
Research Support ◽  
Trivalent Influenza Vaccine ◽  
Influenza Activity ◽  
The U.S

Abstract Background Influenza vaccine effectiveness decreases with increasing age due to the senescence of immune function and a reduced immune response to antigens. There is also considerable vaccine effectiveness heterogeneity depending on the influenza activity time period, especially in seasons where two different circulating strains predominated, such as the 2018–19 season. This research aimed to assess the effect of age and high influenza activity period (HIAP) on the relative vaccine effectiveness (rVE) of adjuvanted trivalent influenza vaccine (aTIV) vs. trivalent high-dose influenza vaccine (HD-TIV) among elderly (≥65y) recipients in the U.S. Methods During the 2018–19 influenza season, a retrospective cohort analysis was conducted using professional fee, prescription claims and hospital charge master data in the U.S. The first sub-analysis evaluated rVE for different age groups (65–74 years, 75–84 years, ≥85 years). The second sub-analysis evaluated rVE overall, restricting the observation period from to HAIP: Dec 2018-Mar 2019 (August 2018-July 2019 in the main analysis). Adjusted analyses were conducted through inverse probability of treatment weighting (IPTW) to control for selection bias. Poisson regression was used to estimate the adjusted pairwise rVE for influenza-related hospitalizations/emergency room (ER) visits and office visits. Results Following IPTW, 561,315 recipients of aTIV and 1,672,779 of TIV-HD were identified. Following IPTW adjustment and Poisson regression, aTIV was more effective in reducing influenza-related office visits compared to TIV-HD (7.0%; 95% CI: 2.6%-11.2%) in the HIAP sub-analysis. In the age sub-analysis, the rVE favoring aTIV ranged from 5.1% (95% CI: -0.17%-10.1%) for the youngest group (65–74) up to 11.4% (95% CI: 0.6%-21.1%) for the eldest group (≥85y) for influenza-related office visits. No statistically significant differences were found for aTIV compared to TIV-HD for prevention of influenza-related hospitalizations/ER visits in the sub-analyses evaluated. Conclusion In adjusted analyses, aTIV reduced influenza-related office visits compared to TIV-HD within the two older age groups and HIAP sub-analysis. aTIV and TIV-HD demonstrated comparable reductions in influenza-related hospitalizations/ER visits. Disclosures Maarten Postma, Dr., IQVIA (Consultant) Stephen I. Pelton, MD, Merck vaccine (Consultant, Grant/Research Support)Pfizer (Consultant, Grant/Research Support)Sanofi Pasteur (Consultant, Other Financial or Material Support, DSMB)Seqirus Vaccine Ltd. (Consultant) Victoria Divino, PhD, Seiqrus Vaccines Ltd. (Consultant) Joaquin F. Mould-Quevedo, PhD, Seqirus Vaccines Ltd. (Employee, Shareholder) Drishti Shah, PhD, Seqirus Vaccines Ltd. (Consultant) Mitchell DeKoven, PhD, Seqirus Vaccines Ltd. (Consultant)

scholarly journals Comparative effectiveness of high dose versus adjuvanted influenza vaccine: A retrospective cohort study

Vaccine ◽  
2020 ◽  
Vol 38 (2) ◽  
pp. 372-379 ◽  
Author(s):  
Robertus van Aalst ◽  
Stefan Gravenstein ◽  
Vincent Mor ◽  
Salaheddin M. Mahmud ◽  
Jan Wilschut ◽  
...  
Keyword(s):  
Cohort Study ◽  
Influenza Vaccine ◽  
Retrospective Cohort Study ◽  
Comparative Effectiveness ◽  
Retrospective Cohort ◽  
High Dose

scholarly journals Economic assessment of a high-dose versus a standard-dose influenza vaccine in the US Veteran population: Estimating the impact on hospitalization cost for cardio-respiratory disease

Vaccine ◽  
2019 ◽  
Vol 37 (32) ◽  
pp. 4499-4503 ◽  
Author(s):  
Robertus van Aalst ◽  
Ellyn M. Russo ◽  
Nabin Neupane ◽  
Salaheddin M. Mahmud ◽  
Vincent Mor ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Respiratory Disease ◽  
Standard Dose ◽  
Economic Assessment ◽  
High Dose ◽  
Hospitalization Cost ◽  
The Us ◽  
The Impact

scholarly journals LB-2. Relative Effectiveness of aIIV3 versus IIV4 and HD-IIV3 In Preventing Influenza-Related Medical Encounters in Adults ≥65 Years of Age at High Risk for Influenza Complications During the U.S. 2017–2018 and 2018–2019 Influenza Seasons

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S844-S844
Author(s):  
Lauren Fischer ◽  
Dan O'Brien ◽  
Joseph Vasey ◽  
Gregg C Sylvester ◽  
James A Mansi
Keyword(s):  
High Risk ◽  
Influenza Vaccine ◽  
Relative Effectiveness ◽  
Health Condition ◽  
Geographic Region ◽  
Vaccine Effectiveness ◽  
High Dose ◽  
Icd 10 ◽  
Risk Patients ◽  
The U.S

Abstract Background Individuals with health conditions have shown higher rates of influenza-related morbidity and mortality compared to healthy individuals and are often prioritized for influenza vaccination. However, vaccination with egg-derived standard quadrivalent inactivated influenza vaccines (IIV4) has shown to be less effective in adults ≥65 years of age largely due to immunosenecence. Two enhanced vaccines, the MF59®-adjuvanted trivalent inactivated influenza vaccine (aIIV3) and a high-dose trivalent inactivated influenza vaccine (HD-IIV3), were developed to provide adults ≥65 years with increased protection. The objective of this study was to determine the relative vaccine effectiveness (rVE) of aIIV3 versus IIV4 and HD-IIV3 in preventing influenza-related medical encounters in high-risk adults ≥65 years. Methods A retrospective cohort study was conducted among adults ≥65 years with ≥1 health condition with a record of receiving either aIIV3, IIV4 or HD-IIV3 in the 2017–18 or 2018–19 influenza seasons. Patient-level electronic medical records linked to pharmacy and medical claims were used to ascertain exposure, outcome and covariate information. The primary outcome was influenza-related medical encounters in primary care and hospital (ICD-10 codes J09*–J11*). Inverse probability of treatment weighting was used to obtain odds ratios (ORs) adjusted for age, sex, race, ethnicity, geographic region, comorbidities and week of vaccination for each health condition. rVE was determined using the formula (1-OR)*100 and reported with 95% confidence intervals (CI). Results Overall, 1,755,420 individuals with ≥1 health condition were included for analysis in the 2017–18 season and 2,055,012 individuals in the 2018–19 season. In both seasons, high-risk subjects who received aIIV3 had statistically significantly greater reduction in influenza-related medical encounters as compared to IIV4 (Table 1). Non-statistically significant estimates preclude definitive conclusions for comparisons with HD-IIV3. Table 1. Adjusted relative vaccine effectiveness (rVE) of aIIV3 versus comparators in high-risk patients in the 2017–2018 and 2018–2019 influenza seasons in the U.S. Conclusion The results of this study support the use of aIIV3 in adults ≥65 years of age at high risk for influenza complications and provides further evidence supporting aIIV3 as an effective public health measure against influenza. Disclosures Lauren Fischer, M.A., Seqirus (Consultant) Dan O'Brien, BA, Seqirus (Consultant) Joseph Vasey, PhD, Seqirus (Consultant) Gregg C. Sylvester, MD, Seqirus (Employee) James A. Mansi, PhD, Seqirus (Employee)

IMPACT OF CHILDHOOD ASTHMA ON HEALTH

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 255-256
Author(s):  
Christopher Randolph
Keyword(s):  
Functional Disability ◽  
Severe Disease ◽  
Asthma Management ◽  
Black Children ◽  
Children With Asthma ◽  
Interview Survey ◽  
Study Population ◽  
The Difference ◽  
The U.S

Purpose of the Study. To determine the disease burden resulting from asthma and to determine the functional status of asthmatics versus those without. Study Population. A multi-state probability sample of civilian U.S. residents for the National Health Interview Survey (NHIS); 17 110 households of individuals residing in the U.S. Findings. The prevalence of asthma in children under 18 years of age in the U.S. was 4.3% in 1988 and 3.2% in 1981 . The difference between the prevalence of asthma was statistically significant with an estimated 2.7 million children <18 years of age reported to have asthma over the past year. The added burden experienced by children with asthma was an additional 10.1 million days missed from school, 12.9 million contacts with medical doctors and 200 000 hospitalizations. 30% of children had limitation of activity compared to 5% without asthma. Black children had more severe functional disability and hospitalizations than whites with asthma. 35% of hospitalizations for asthma and 77% of all days in the hospital were accounted for by 10% of children with asthma or severe disease. Reviewer's Comments. These statistics are largely preventable with preventive asthma management reiterated to the patients and frequent follow up visits.

Sign in / Sign up

Export Citation Format

Share Document