[Economic and Health impact of influenza vaccination with adjuvant MF59 in population over 64 years in Spain]. / Impacto económico y sanitario de la utilización de vacuna antigripal adyuvada con MF59 en población mayor de 65 años en España.

OBJECTIVE: Influenza is an important health problem due to the mortality it can cause directly or indirectly as well as the complications and the economic and social costs it produces. Influenza epidemics are being addressed through vaccination campaigns aimed at preventing cases and complications, and the vaccine is officially recommended, as in the case of Spain, for certain risk groups, such as older people, chronic diseases and institutionalized population. The adjuvanted influenza vaccine with MF59, indicated for population over 65 years, has been shown to be more immunogenic than conventional influenza vaccines. The objective of this study is to assess the impact on the national and regional budget of the seasonal vaccination campaigns carried out in Spain using the MF59 adjuvanted vaccine compared to a conventional vaccine in a population older than 65 years. METHODS: We analyzed the budgetary impact of the use of the MF59-adjuvanted vaccine in the national territory and by Autonomous Communities through a modeling of two alternatives, conventional vaccination versus adjuvant vaccination with MF59 in a population older than 65 years. The cases of avoided influenza, avoided complications and avoided costs, as well as the economic impact of the vaccination program have been calculated. RESULTS: With the available information, the budgetary impact of using the influenza vaccine with MF59 in all the over 65 years, amounts to 6,967,288.10 €, avoiding for the national set a cost of 89.5 million Euros, which represents a potential savings of 82 million Euros and a cost-benefit ratio of 12.83. CONCLUSIONS: The use of the influenza vaccine with the MF59 adjuvant to all those over 65 years would mean an increase in the efficiency of the vaccination programs currently proposed in all the Autonomous Communities and in the Spanish state.

Pharmacoeconomic evaluation of the MF59--adjuvanted influenza vaccine in the elderly population in Italy.

INTRODUCTION: Influenza vaccination has proven effective in the reduction of influenza-like illness (ILI) cases and influenza-related hospitalizations, drug consumption, primary care consultations and deaths in the elderly population. The aim of this study is the assessment of the financial budget impact of a seasonal vaccination program based on the use of the MF59 adjuvanted vaccine as compared with the traditional vaccine or the absence of vaccination in Italian elderly population. METHODS: A pharmacoeconomic simulation model was developed to simulate the effect of the three different vaccination programs during a single influenza season. Health economics and demographic data were taken from specific Italian sources, and vaccine effectiveness data derived from published literature. Direct medical costs were considered according to current Italian prices and tariffs. RESULTS: About 83% of the 12 million people of at least 65 years of age currently resident in Italy can be considered at high risk for influenza complications due to underlying chronic diseases. Absence of vaccination could lead to more than 2 million ILl cases, and 29,000 related deaths. The vaccination program with a coverage rate of 65.6% would lead to an estimated 1.5 million ILl cases (26.9% reduction) with a standard vaccine and to 1.3 million (35.8% reduction) with the MF59 adjuvanted vaccine with a relative increase of avoided cases of 33,1%. The standard vaccination program produced a moderate direct cost increase of about 50 million Euro (+4.6%), whereas the adjuvanted vaccine provided an estimated saving of about 74 million Euro (-6.8%), both compared to the non vaccination. Cost savings were mainly related to hospital admissions avoided in the elderly population (>or=65 years of age). CONCLUSIONS: The vaccination with the MF59 adjuvanted vaccine resulted more effective and cost saving when compared with the standard vaccination and with no vaccination, thus representing the optimal strategy for the elderly population. The standard vaccine, even though a light cost increase, still proved to be effective compared to the null option, with the initial cost for the vaccination program nearly offset by healthcare resources savings obtained during the season.