Details:

Alternative Title:
Am J Kidney Dis
Publisher's site:
http://dx.doi.org/10.1053/j.ajkd.2010.12.016
Personal Author:
Lee, Bruce Y. ; Stalter, Randy M. ; Bacon, Kristina M. ; Tai, Julie H.Y. ; Bailey, Rachel R. ; ... More +
Lee, Bruce Y. ; Stalter, Randy M. ; Bacon, Kristina M. ; Tai, Julie H.Y. ; Bailey, Rachel R. ; Zimmer, Shanta M. ; Wagner, Michael M. ; Less -
Description:
Background Currently, over 340,000 individuals are receiving long-term hemodialysis (HD) therapy for end-stage renal disease and therefore are particularly vulnerable to influenza, prone to more severe influenza outcomes, and less likely to achieve seroprotection from standard influenza vaccines. Influenza vaccine adjuvants, chemical or biological compounds added to a vaccine to boost the elicited immunological response, may help overcome this problem. Study design Economic stochastic decision analytic simulation model. Setting & Participants United States adult HD population. Model, Perspective, & Timeframe The model simulated the decision to use either an adjuvanted or non-adjuvanted vaccine, assumed the societal perspective, and represented a single influenza season, or 1 year. Intervention Adjuvanted influenza vaccine at different adjuvant costs and efficacies. Sensitivity analyses explored the impact of varying the influenza clinical attack rate, influenza hospitalization rate, and influenza-related mortality. Outcomes Incremental cost-effectiveness ratio (ICER) of adjuvanted influenza vaccine (versus non-adjuvanted) with effectiveness measured in quality-adjusted life-years (QALYs). Results Adjuvanted influenza vaccine would be cost-effective (ICER<$50,000/QALY) at a $1 adjuvant cost (on top of the standard vaccine cost) when the adjuvant efficacy (in overcoming the difference between influenza vaccine response in HD patients and healthy adults) ≥60% and economically dominant (provides both cost savings and health benefits) when the $1 adjuvant's efficacy is 100%. A $2 adjuvant would be cost-effective should the adjuvant efficacy be 100%. Limitations All models are simplifications of real life and cannot possibly capture all possible factors and outcomes. Conclusions An adjuvanted influenza vaccine with adjuvant cost ≤$2 could be cost-effective strategy in a standard influenza season depending on the potency of the adjuvant.
Subject:
[+]
Adjuvants, Immunologic
Adult
Aged
Article
Computer Model
Computer Simulation
Cost-Benefit Analysis
Cost-effectiveness
Decision Trees
End-Stage Renal Disease
Female
Hemodialysis
Humans
Immunodeficiency
Influenza, Human
Influenza Vaccine
Influenza Vaccines
Kidney Failure, Chronic
Male
Middle Aged
Renal Dialysis
Seasonal Influenza
Vaccine Adjuvant

Source:
Am J Kidney Dis. 2011; 57(5):724-732.
Pubmed ID:
21396760
Pubmed Central ID:
PMC3085888
Document Type:
Journal Article ;
Funding:
R01 LM009132-04/LM/NLM NIH HHS/United States ; U54 GM088491-02/GM/NIGMS NIH HHS/United States ; 5R01LM009132-03/LM/NLM NIH HHS/United States ; 5U54GM088491-02/GM/NIGMS NIH HHS/United States ; P01 HK000086/HK/PHITPO CDC HHS/United States ; ... More +
R01 LM009132-04/LM/NLM NIH HHS/United States ; U54 GM088491-02/GM/NIGMS NIH HHS/United States ; 5R01LM009132-03/LM/NLM NIH HHS/United States ; 5U54GM088491-02/GM/NIGMS NIH HHS/United States ; P01 HK000086/HK/PHITPO CDC HHS/United States ; U54 GM088491/GM/NIGMS NIH HHS/United States ; R01 LM009132/LM/NLM NIH HHS/United States ; 5P01HK000086-02/HK/PHITPO CDC HHS/United States ; Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:b82ebd5e8d921738c73a74a383d63ecbed3342a58339cb13ee0e81cdb2f7503b
File Type:

Supporting Files

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