[Cost-effective analysis of seasonal influenza vaccine in elderly Chinese population].

Objective: To evaluate the cost-effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China. Methods: A static life-time Markov model is conducted to simulate the Chinese elderly population aged ≥60 years old. Taking the health care system perspective, one-year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality-adjusted life year (QALY) (193 932/QALY), the incremental cost-effectiveness ratio (ICER) was calculated to compare the cost-effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One-way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output. Results: The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. Conclusion: Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost-effective compared to no vaccination in elderly Chinese population.目的： 分析中国老人接种流感疫苗的成本效果。 方法： 研究对象为中国60岁及以上的老人，采用静态马尔科夫模型，基于医疗保健系统角度，以1年为循环周期，研究时限到100岁，从成本和效果两个维度评价每年接种三价流感疫苗、四价流感疫苗以及不接种流感疫苗的终身成本和效果，并计算增量成本效果比（ICER），以3倍人均国内生产总值（GDP）（193 932元/QALY）作为社会意愿支付1个QALY的阈值进行评价。成本和健康效用均来源于基于中国人群的临床试验或流感监测网络数据，效果用获得的质量调整寿命年（QALY）表示。通过单因素敏感性分析和概率敏感性分析明确参数的不确定性对结果的影响。 结果： 不接种流感疫苗的人均医疗成本为603元，接种三价疫苗的人均医疗成本为1 027元，相对于不接种疫苗，接种三价疫苗人均可获得0.007个QALY，增量成本为424元，增量成本效果比（ICER）是64 026元/QALY，低于3倍人均GDP。接种四价疫苗的人均医疗成本为1 988元，相对于不接种流感疫苗，接种四价疫苗人均可获得0.008个QALY，增量成本为1 385元，ICER值为174 081元/QALY，低于3倍人均GDP。 结论： 接种三价流感和四价流感疫苗均比不接种流感疫苗给老人带来更高的健康效用，且均具有良好成本效果。.