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Introduction and objectives <p>Influenza is a widespread acute respiratory illness which represents a significant public health challenge from both the National Health Service (NHS) and societal perspective, especially in the older adults. The aim of this study was to assess the cost-effectiveness of influenza vaccination with a high-dose quadrivalent vaccine (HD-QIV) versus a standard dose quadrivalent vaccine (SD-QIV) in the older adults in Spain.</p> Methods <p>We assessed the public health and economic benefits of various alternatives using a decision-tree model. This model considered factors such as influenza cases, visits to general practitioners (GP), emergency department (ED) visits, hospitalizations due to cardiorespiratory events, and influenza-related mortality. To address uncertainties deriving from both epidemiological and economic sources, we conducted deterministic and probabilistic sensitivity analyses.</p> Results <p>From a societal perspective, HD-QIV compared to SD-QIV prevented during an influenza season 54,039 influenza cases, 7,733 GP consultations, 1,585 ED visits, 30,772 episodes of hospitalization due to cardiorespiratory events over a single influenza season and 1,203 deaths when vaccinating adults ≥ 65&#xa0;years old in Spain, resulting in 14,316 LYs and 12,545 QALYs gained over a lifetime horizon. The reduction in health outcomes outweighed the increase in vaccination costs, translating to a reduction in total costs with HD-QIV compared to SD-QIV. Therefore, vaccinating older adults in Spain with HD-QIV instead of SD-QIV was a dominant strategy when evaluating hospitalizations due to cardiorespiratory events. HD-QIV remained dominant from an NHS perspective. Sensitivity analyses confirmed the robustness of the model.</p> Conclusions <p>This analysis showed that vaccinating older adults in Spain with HD-QIV instead of SD-QIV would reduce cases of influenza, GP and ED visits, hospitalizations, deaths, and associated costs, and thus it should be the strategy of choice in a situation of budgetary constraints from either a societal or an NHS perspective.</p>

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Cost-effectiveness analysis of influenza vaccination with high-dose vaccine versus standard-dose quadrivalent vaccine in older adults in Spain

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月4日

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  • Jose-Maria Abellan-Perpiñan,
  • Esther Redondo Margüello,
  • Ángel Gil de Miguel,
  • Iván Sanz Muñoz,
  • Ariadna Diaz-Aguiló,
  • Paloma Palomo,
  • Manel Farré,
  • Daniel Callejo,
  • Marco Pinel,
  • Juan Luis López-Belmonte

摘要

Introduction and objectives

Influenza is a widespread acute respiratory illness which represents a significant public health challenge from both the National Health Service (NHS) and societal perspective, especially in the older adults. The aim of this study was to assess the cost-effectiveness of influenza vaccination with a high-dose quadrivalent vaccine (HD-QIV) versus a standard dose quadrivalent vaccine (SD-QIV) in the older adults in Spain.

Methods

We assessed the public health and economic benefits of various alternatives using a decision-tree model. This model considered factors such as influenza cases, visits to general practitioners (GP), emergency department (ED) visits, hospitalizations due to cardiorespiratory events, and influenza-related mortality. To address uncertainties deriving from both epidemiological and economic sources, we conducted deterministic and probabilistic sensitivity analyses.

Results

From a societal perspective, HD-QIV compared to SD-QIV prevented during an influenza season 54,039 influenza cases, 7,733 GP consultations, 1,585 ED visits, 30,772 episodes of hospitalization due to cardiorespiratory events over a single influenza season and 1,203 deaths when vaccinating adults ≥ 65 years old in Spain, resulting in 14,316 LYs and 12,545 QALYs gained over a lifetime horizon. The reduction in health outcomes outweighed the increase in vaccination costs, translating to a reduction in total costs with HD-QIV compared to SD-QIV. Therefore, vaccinating older adults in Spain with HD-QIV instead of SD-QIV was a dominant strategy when evaluating hospitalizations due to cardiorespiratory events. HD-QIV remained dominant from an NHS perspective. Sensitivity analyses confirmed the robustness of the model.

Conclusions

This analysis showed that vaccinating older adults in Spain with HD-QIV instead of SD-QIV would reduce cases of influenza, GP and ED visits, hospitalizations, deaths, and associated costs, and thus it should be the strategy of choice in a situation of budgetary constraints from either a societal or an NHS perspective.