Garcia, AmosOrtíz de Lejarazu, RaúlReina, JordiCallejo, DanielCuervo, JesusMorano Larragueta, Raul2024-07-092024-07-092016Garcia A, Ortiz De Lejarazu R, Reina J, Callejo D, Cuervo J, Morano Larragueta R. Cost-effectiveness analysis of quadrivalent influenza vaccine in Spain. Human Vaccines Immunother. 2016;12(9):2269-77. Epub 2016 May 16.2164-5515http://hdl.handle.net/20.500.13003/10527http://hdl.handle.net/20.500.12105/20304Influenza has a major impact on healthcare systems and society, but can be prevented using vaccination. The World Health Organization (WHO) currently recommends that influenza vaccines should include at least two virus A and one virus B lineage (trivalent vaccine; TIV). A new quadrivalent vaccine (QIV), which includes an additional B virus strain, received regulatory approval and is now recommended by several countries. The present study estimates the cost-effectiveness of replacing TIVs with QIV for risk groups and elderly population in Spain. A static, lifetime, multi-cohort Markov model with a one-year cycle time was adapted to assess the costs and health outcomes associated with a switch from TIV to QIV. The model followed a cohort vaccinated each year according to health authority recommendations, for the duration of their lives. National epidemiological data allowed the determination of whether the B strain included in TIVs matched the circulating one. Societal perspective was considered, costs and outcomes were discounted at 3% and one-way and probabilistic sensitivity analyses were performed. Compared to TIVs, QIV reduced more influenza cases and influenza-related complications and deaths during periods of B-mismatch strains in the TIV. The incremental cost-effectiveness ratio (ICER) was 8,748Euro/quality-adjusted life year (QALY). One-way sensitivity analysis showed mismatch with the B lineage included in the TIV was the main driver for ICER. Probabilistic sensitivity analysis shows ICER below 30,000Euro/QALY in 96% of simulations. Replacing TIVs with QIV in Spain could improve influenza prevention by avoiding B virus mismatch and provide a cost-effective healthcare intervention.enghttps://creativecommons.org/licenses/by/3.0/Costs and cost analysisCost-effectiveness analysisHumanHealthcare costsInfluenzaInfluenza B virusInfluenza vaccinesQIVVaccinesChildresearch articleAttribution 3.0 Unported271846221292269-227710.1080/21645515.2016.11822752164-554XHuman Vaccines & Immunotherapeuticsopen accessFemeninoLactanteAnálisis Costo-BeneficioGripe HumanaAdolescenteVacunas contra la InfluenzaMasculinoPreescolarHumanosPersona de Mediana EdadAdulto JovenEmbarazoAncianoAnciano de 80 o más AñosNiñoCosto de EnfermedadAdultoEspaña2-s2.0-84978543516384217200021L611287053