Cost-effectiveness of introducing national seasonal influenza vaccination for adults aged 60 years and above in mainland China: a modelling analysis

Juan Yang, Katherine E. Atkins, Luzhao Feng, Marc Baguelin, Peng Wu, Han Yan, Eric H. Y. Lau, Joseph T. Wu, Yang Liu, Benjamin J. Cowling, Mark Jit, Hongjie Yu

Research output: Contribution to journalArticlepeer-review

Abstract

Background
China has an aging population with an increasing number of adults aged ≥ 60 years. Influenza causes a heavy disease burden in older adults, but can be alleviated by vaccination. We assessed the cost-effectiveness of a potential government-funded seasonal influenza vaccination program in older adults in China.
Methods
We characterized the health and economic impact of a fully funded influenza vaccination program for older adults using China-specific influenza disease burden, and related cost data, etc. Using a decision tree model, we calculated the incremental costs per quality-adjusted life year (QALY) gained of vaccination from the societal perspective, at a willingness-to-pay threshold equivalent to GDP per capita (US$8840). Moreover, we estimated the threshold vaccination costs, under which the fully funded vaccination program is cost-effective using GDP per capita as the willingness-to-pay threshold.
Results
Compared to current self-paid vaccination, a fully funded vaccination program is expected to prevent 19,812 (95% uncertainty interval, 7150–35,783) influenza-like-illness outpatient consultations per year, 9418 (3386–17,068) severe acute respiratory infection hospitalizations per year, and 8800 (5300–11,667) respiratory excess deaths due to influenza per year, and gain 70,212 (42,106–93,635) QALYs per year. Nationally, the incremental costs per QALY gained of the vaccination program is US$4832 (3460–8307), with a 98% probability of being cost-effective. The threshold vaccination cost is US$10.19 (6.08–13.65). However, variations exist between geographical regions, with Northeast and Central China having lower probabilities of cost-effectiveness.
Conclusions
Our results support the implementation of a government fully funded older adult vaccination program in China. The regional analysis provides results across settings that may be relevant to other countries with similar disease burden and economic status, especially for low- and middle-income countries where such analysis is limited.
Original languageEnglish
JournalBMC Medicine
Volume18
Issue number1
Early online date14 Apr 2020
DOIs
Publication statusE-pub ahead of print - 14 Apr 2020

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