scholarly journals The Epidemiological and Economic Impact of a Cell-Based Quadrivalent Influenza Vaccine in Adults in the US: A Dynamic Modeling Approach

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1095
Author(s):  
Van Hung Nguyen ◽  
Yvonne Hilsky ◽  
Joaquin Mould-Quevedo
Keyword(s):  
Public Health ◽  
Influenza Vaccine ◽  
Economic Impact ◽  
Influenza Vaccines ◽  
Sensitivity Analyses ◽  
Life Years ◽  
The Us ◽  
A Cell ◽  
The Impact ◽  
Quadrivalent Influenza Vaccine

Mutations of the H3N2 vaccine strain during the egg-based vaccine manufacturing process partly explain the suboptimal effectiveness of traditional seasonal influenza vaccines. Cell-based influenza vaccines improve antigenic match and vaccine effectiveness by avoiding such egg-adaptation. This study evaluated the public health and economic impact of a cell-based quadrivalent influenza vaccine (QIVc) in adults (18–64 years) compared to the standard egg-based quadrivalent influenza vaccine (QIVe) in the US. The impact of QIVc over QIVe in public health and cost outcomes was estimated using a dynamic age-structured SEIR transmission model, which accounted for four circulating influenza strains [A/H1N1pdm9, A/H3N2, B(Victoria), and B(Yamagata)] and was calibrated on the 2013–2018 influenza seasons. The robustness of the results was assessed in univariate and probabilistic sensitivity analyses. Switching from QIVe to QIVc in 18- to 64-year-olds may prevent 5.7 million symptomatic cases, 1.8 million outpatient visits, 50,000 hospitalizations, and 5453 deaths annually. The switch could save 128,000 Quality-Adjusted Life Years (QALYs) and US $ 845 M in direct costs, resulting in cost-savings in a three-year time horizon analysis. Probabilistic sensitivity analyses confirmed the robustness of the cost-saving result. The analysis shows that QIVc is expected to prevent hospitalizations and deaths, and result in substantial savings in healthcare costs.

scholarly journals The Epidemiological and Economic Impact of a Cell-Based Quadrivalent Influenza Vaccine in an Adult Population in the US: A Dynamic Modeling Approach

2020 ◽  
Author(s):  
Van Hung Nguyen ◽  
Yvonne Hilsky ◽  
Joaquin Mould-Quevedo
Keyword(s):  
Public Health ◽  
Cost Saving ◽  
Influenza Vaccine ◽  
Economic Impact ◽  
Adult Population ◽  
Vaccine Effectiveness ◽  
The Us ◽  
A Cell ◽  
The Impact ◽  
Quadrivalent Influenza Vaccine

Abstract Background: Mutations of the H3N2 vaccine strain during the egg-based vaccine manufacturing process seem to partly explain the suboptimal effectiveness of traditional seasonal influenza vaccine. Cell-based influenza vaccines avoid such egg-adaptation, thereby improving antigenic match and vaccine effectiveness. The objective of this study was to evaluate the public health and economic impact of a cell-based quadrivalent influenza vaccine (QIVc) in adult population (18-64 years) compared to the standard egg-based quadrivalent influenza vaccine (QIVe), in the US. Methods: The impact of QIVc over QIVe in terms of public health and costs outcomes was estimated using a dynamic SEIR transmission model. The model is age-structured and accounts for 4 circulating influenza strains (A/H1N1pdm9, A/H3N2, B(Victoria), and B(Yamagata)). It was calibrated on US attack rate and strain circulation for the influenza seasons 2013-2018. US specific absolute vaccine effectiveness for QIVe, specific hospitalization rate, mortality rate, Quality-Adjusted Life Years (QALYs) and costs were extracted from published literature. Relative vaccine effectiveness of QIVc over QIVe for subjects 18-64 years of age was obtained from a US retrospective cohort study. Robustness of the results was assessed in univariate and probabilistic sensitivity analyses.Results: Switching from QIVe to QIVc in the 18-64 year-old population may prevent 5.7 M symptomatic cases, 1.8 M outpatient visits; 50K hospitalizations and 5,453 deaths annually. The switch could save 128 K QALYs and US$ 845M in direct costs, resulting in a cost-saving alternative in a 3-year time horizon analysis. Probabilistic sensitivity analyses confirmed the robustness of the cost-saving result.Conclusions: The analysis shows that QIVc is expected to prevent a substantial number of hospitalizations and deaths, and would result in substantial savings in health care costs.

scholarly journals The epidemiological and economic impact of a cell-based quadrivalent influenza vaccine in an adult population in the US: a dynamic modeling approach

2020 ◽  
Author(s):  
Van Hung Nguyen ◽  
Yvonne Hilsky ◽  
Joaquin Mould-Quevedo
Keyword(s):  
Public Health ◽  
Cost Saving ◽  
Influenza Vaccine ◽  
Economic Impact ◽  
Adult Population ◽  
Vaccine Effectiveness ◽  
Transmission Model ◽  
Life Years ◽  
A Cell ◽  
Quadrivalent Influenza Vaccine

Abstract BackgroundMutations of the H3N2 vaccine strain during the egg-based vaccine manufacturing process seem to partly explain the suboptimal effectiveness of traditional seasonal influenza vaccine. Cell-based influenza vaccines avoid such egg-adaptation, thereby improving antigenic match and vaccine effectiveness. The objective of this study was to evaluate the public health and economic impact of a cell-based quadrivalent influenza vaccine (QIVc) in adult population (18–64 years) compared to the standard egg-based quadrivalent influenza vaccine (QIVe), in the US.MethodsThe impact of QIVc over QIVe in terms of public health and costs outcomes was estimated using a dynamic SEIR transmission model. The model is age-structured and accounts for 4 circulating influenza strains (A/H1N1pdm9, A/H3N2, B(Victoria), and B(Yamagata)). It was calibrated on US attack rate and strain circulation for the seasons 2013–2018. US specific absolute vaccine effectiveness for QIVe, specific hospitalization rate, mortality rate, Quality-Adjusted Life Years (QALYs) and costs were extracted from published literature. Relative vaccine effectiveness of QIVc over QIVe for subjects 18–64 years of age was obtained from a US retrospective cohort study. Robustness of the results was assessed in univariate and probabilistic sensitivity analyses.ResultsSwitching from QIVe to QIVc in the 18–64 year-old population may prevent 5.7 M symptomatic cases, 1.8 M outpatient visits; 50K hospitalizations and 5,453 deaths annually. The switch could save 128 K QALYs and US$ 845M in direct costs, resulting in a cost-saving alternative in a 3-year time horizon analysis. Probabilistic sensitivity analyses confirmed the robustness of the cost-saving result.ConclusionsThe analysis shows that QIVc is expected to prevent a substantial number of hospitalizations and deaths, and would result in substantial savings in health care costs.

scholarly journals A Real-World Clinical and Economic Analysis of Cell-derived Quadrivalent Influenza Vaccine Compared to Standard Egg-derived Quadrivalent Influenza Vaccines During the 2019-20 Influenza Season in the United States

2021 ◽  
Author(s):  
Victoria Divino ◽  
Vamshi Ruthwik Anupindi ◽  
Mitch DeKoven ◽  
Joaquin Mould-Quevedo ◽  
Stephen I Pelton ◽  
...  
Keyword(s):  
High Risk ◽  
Influenza Vaccine ◽  
Influenza Season ◽  
The United States ◽  
Vaccine Effectiveness ◽  
Influenza Vaccines ◽  
Sensitivity Analyses ◽  
Administrative Claims ◽  
Adaptive Mutations ◽  
Quadrivalent Influenza Vaccine

Abstract Background Cell-derived influenza vaccines are not subject to egg adaptive mutations that have potential to decrease vaccine effectiveness. This retrospective analysis estimated the relative vaccine effectiveness (rVE) of cell-derived quadrivalent influenza vaccine (IIV4c) compared to standard egg-derived quadrivalent influenza vaccines (IIV4e) among recipients aged 4-64 years in the US during the 2019-20 influenza season. Methods The IQVIA PharMetrics® Plus administrative claims database was utilized. Study outcomes were assessed post-vaccination through the end of the study period (March 7, 2020). Inverse probability of treatment weighting (IPTW) was implemented to adjust for covariate imbalance. Adjusted rVE against influenza-related hospitalizations/emergency room (ER) visits and other clinical outcomes was estimated through IPTW-weighted Poisson regression models for the IIV4c and IIV4e cohorts and for the subgroup with ≥1 high-risk condition. Sensitivity analyses modifying the outcome assessment period as well as a doubly-robust analysis were also conducted. IPTW-weighted generalized linear models were used to estimate predicted annualized all-cause costs. Results The final sample comprised 1,138,969 IIV4c and 3,926,357 IIV4e recipients following IPTW adjustment. IIV4c was more effective in preventing influenza-related hospitalizations/ER visits as well as respiratory-related hospitalizations/ER visits compared to IIV4e. IIV4c was also more effective for the high-risk subgroup and across the sensitivity analyses. IIV4c was also associated with significantly lower annualized all-cause total costs compared to IIV4e (-$467), driven by lower costs for outpatient medical services and inpatient hospitalizations. Conclusions IIV4c was significantly more effective in preventing influenza-related hospitalizations/ER visits compared to IIV4e and was associated with significantly lower all-cause costs.

scholarly journals Burden of disease and productivity impact of Streptococcus suis infection in Thailand

2021 ◽  
Vol 15 (1) ◽  
pp. e0008985
Author(s):  
Ajaree Rayanakorn ◽  
Zanfina Ademi ◽  
Danny Liew ◽  
Learn-Han Lee
Keyword(s):  
Public Health ◽  
Economic Burden ◽  
Transition Probabilities ◽  
Productivity Loss ◽  
Sensitivity Analyses ◽  
Years Of Life Lost ◽  
Uncertainty Interval ◽  
Life Years ◽  
Working Age ◽  
The Impact

Background Streptoccocus suis (S.suis) infection is a neglected zoonosis disease in humans mainly affects men of working age. We estimated the health and economic burden of S.suis infection in Thailand in terms of years of life lost, quality-adjusted life years (QALYs) lost, and productivity-adjusted life years (PALYs) lost which is a novel measure that adjusts years of life lived for productivity loss attributable to disease. Methods A decision-analytic Markov model was developed to simulate the impact of S. suis infection and its major complications: death, meningitis and infective endocarditis among Thai people in 2019 with starting age of 51 years. Transition probabilities, and inputs pertaining to costs, utilities and productivity impairment associated with long-term complications were derived from published sources. A lifetime time horizon with follow-up until death or age 100 years was adopted. The simulation was repeated assuming that the cohort had not been infected with S.suis. The differences between the two set of model outputs in years of life, QALYs, and PALYs lived reflected the impact of S.suis infection. An annual discount rate of 3% was applied to both costs and outcomes. One-way sensitivity analyses and Monte Carlo simulation modeling technique using 10,000 iterations were performed to assess the impact of uncertainty in the model. Key results This cohort incurred 769 (95% uncertainty interval [UI]: 695 to 841) years of life lost (14% of predicted years of life lived if infection had not occurred), 826 (95% UI: 588 to 1,098) QALYs lost (21%) and 793 (95%UI: 717 to 867) PALYs (15%) lost. These equated to an average of 2.46 years of life, 2.64 QALYs and 2.54 PALYs lost per person. The loss in PALYs was associated with a loss of 346 (95% UI: 240 to 461) million Thai baht (US$11.3 million) in GDP, which equated to 1.1 million Thai baht (US$ 36,033) lost per person. Conclusions S.suis infection imposes a significant economic burden both in terms of health and productivity. Further research to investigate the effectiveness of public health awareness programs and disease control interventions should be mandated to provide a clearer picture for decision making in public health strategies and resource allocations.

scholarly journals A real-world study evaluating the relative vaccine effectiveness of a cell-based quadrivalent influenza vaccine compared to egg-based quadrivalent influenza vaccine in the US during the 2017–18 influenza season

Vaccine ◽  
2020 ◽  
Vol 38 (40) ◽  
pp. 6334-6343 ◽  
Author(s):  
Victoria Divino ◽  
Girishanthy Krishnarajah ◽  
Stephen I. Pelton ◽  
Joaquin Mould-Quevedo ◽  
Vamshi Ruthwik Anupindi ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Real World ◽  
Influenza Season ◽  
Vaccine Effectiveness ◽  
The Us ◽  
A Cell ◽  
Quadrivalent Influenza Vaccine

scholarly journals Impact of public health interventions to curb SARS-CoV-2 spread assessed by an evidence-educated Delphi panel and tailored SEIR model

2021 ◽  
Author(s):  
Bernd Brüggenjürgen ◽  
Hans-Peter Stricker ◽  
Lilian Krist ◽  
Miriam Ortiz ◽  
Thomas Reinhold ◽  
...  
Keyword(s):  
Public Health ◽  
Transmission Rate ◽  
Latency Period ◽  
Policy Decision ◽  
Sensitivity Analyses ◽  
Delphi Panel ◽  
Time Step ◽  
Seir Model ◽  
Health Policy Decision ◽  
The Impact

Abstract Aim To use a Delphi-panel-based assessment of the effectiveness of different non-pharmaceutical interventions (NPI) in order to retrospectively approximate and to prospectively predict the SARS-CoV-2 pandemic progression via a SEIR model (susceptible, exposed, infectious, removed). Methods We applied an evidence-educated Delphi-panel approach to elicit the impact of NPIs on the SARS-CoV-2 transmission rate R0 in Germany. Effectiveness was defined as the product of efficacy and compliance. A discrete, deterministic SEIR model with time step of 1 day, a latency period of 1.8 days, duration of infectiousness of 5 days, and a share of the total population of 15% assumed to be protected by immunity was developed in order to estimate the impact of selected NPI measures on the course of the pandemic. The model was populated with the Delphi-panel results and varied in sensitivity analyses. Results Efficacy and compliance estimates for the three most effective NPIs were as follows: test and isolate 49% (efficacy)/78% (compliance), keeping distance 42%/74%, personal protection masks (cloth masks or other face masks) 33%/79%. Applying all NPI effectiveness estimates to the SEIR model resulted in a valid replication of reported occurrence of the German SARS-CoV-2 pandemic. A combination of four NPIs at consented compliance rates might curb the CoViD-19 pandemic. Conclusion Employing an evidence-educated Delphi-panel approach can support SARS-CoV-2 modelling. Future curbing scenarios require a combination of NPIs. A Delphi-panel-based NPI assessment and modelling might support public health policy decision making by informing sequence and number of needed public health measures.

scholarly journals Sustainable Tourism, Economic Growth and Employment—The Case of the Wine Routes of Spain

2021 ◽  
Vol 13 (13) ◽  
pp. 7164
Author(s):  
Guillermo Vázquez Vicente ◽  
Victor Martín Barroso ◽  
Francisco José Blanco Jiménez
Keyword(s):  
Economic Growth ◽  
Economic Impact ◽  
Rural Areas ◽  
Local Development ◽  
Tourism Industry ◽  
Wine Tourism ◽  
Development Tool ◽  
The Us ◽  
The Impact ◽  
Positive Effect

Tourism has become a priority in national and regional development policies and is considered a source of economic growth, particularly in rural areas. Nowadays, wine tourism is an important form of tourism and has become a local development tool for rural areas. Regional tourism development studies based on wine tourism have a long history in several countries such as the US and Australia, but are more recent in Europe. Although Spain is a leading country in the tourism industry, with an enormous wine-growing tradition, the literature examining the economic impact of wine tourism in Spanish economy is scarce. In an attempt to fill this gap, the main objective of this paper is to analyze the impact of wine tourism on economic growth and employment in Spain. More specifically, by applying panel data techniques, we study the economic impact of tourism in nine Spanish wine routes in the period from 2008 to 2018. Our results suggest that tourism in these wine routes had a positive effect on economic growth. However, we do not find clear evidence of a positive effect on employment generation.

Public health impact of a US ban on menthol in cigarettes and cigars: a simulation study

2021 ◽  
pp. tobaccocontrol-2021-056604
Author(s):  
David T Levy ◽  
Rafael Meza ◽  
Zhe Yuan ◽  
Yameng Li ◽  
Christopher Cadham ◽  
...  
Keyword(s):  
Public Health ◽  
Smoking Initiation ◽  
Health Impact ◽  
Status Quo ◽  
Expert Elicitation ◽  
Sensitivity Analyses ◽  
Public Health Impact ◽  
Menthol Cigarette ◽  
Life Years ◽  
Life Years Lost

IntroductionThe US Food and Drug Administration most recently announced its intention to ban menthol cigarettes and cigars nationwide in April 2021. Implementation of the ban will require evidence that it would improve public health. This paper simulates the potential public health impact of a ban on menthol in cigarettes and cigars through its impacts on smoking initiation, smoking cessation and switching to nicotine vaping products (NVPs).MethodsAfter calibrating an established US simulation model to reflect recent use trends in cigarette and NVP use, we extended the model to incorporate menthol and non-menthol cigarette use under a status quo scenario. Applying estimates from a recent expert elicitation on the behavioural impacts of a menthol ban, we developed a menthol ban scenario with the ban starting in 2021. We estimated the public health impact as the difference between smoking and vaping-attributable deaths and life-years lost in the status quo scenario and the menthol ban scenario from 2021 to 2060.ResultsAs a result of the ban, overall smoking was estimated to decline by 15% as early as 2026 due to menthol smokers quitting both NVP and combustible use or switching to NVPs. These transitions are projected to reduce cumulative smoking and vaping-attributable deaths from 2021 to 2060 by 5% (650 000 in total) and reduce life-years lost by 8.8% (11.3 million). Sensitivity analyses showed appreciable public health benefits across different parameter specifications.Conclusions and relevanceOur findings strongly support the implementation of a ban on menthol in cigarettes and cigars.

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