ISSN: 2642-6250
Authors: Dari S*, Simeone V and Aquilani S
Introduction: Influenza is an important problem of Public Health and source of costs: it’s the main cause of school and work absences, GP (general practitioner) consultation, hospitalization for the possible implications as well as the third leading cause of death from infectious disease preceded by HIV and Tuberculosis. An Influenza Immunization Program is free and active and it is offered by the Italian Ministry of Health (MoH) for all subjects on the basis of age ≥ 65 years old and for all subjects at a higher risk despite their age or all those subjects that have pathologies that potentially increase the risk for ongoing complications of influenza. These subjects may be vaccinated by MMG (General Practitioners), PLS (family paediatrician) or USL’s (Local Health Administration Unit) Vaccination Centre’s. The Immunization Program takes place every year for three months, commencing from October until December with over 10 million subjects in Italy, of about 15 % of the population. From 2015 -2016, in addition to Trivalent Influenza Vaccine (TIV) Quadrivalent Influenza Vaccine (QIV) is also available. QIV protects against two lineages of virus B, solving the problem for partial and total mismatch: TIVs and QIV have a similar efficacy for what concern Virus A, and similar is their safety. Aim of the Study: The study has been conducted in collaboration with GlaxoSmithKline, Italy’s Payer and Evidence Solution Function through the use of a GSK’s budget impact model. The potentially preventable influenza cases, influenza related complications and hospitalization resulting from an incremental use of Tetravalent vaccine (QIV) in place of Trivalent (TIV) and the relative impact on budget has been analyzed. Methods: Two scenarios were compared, a current one with data on the 2015-2016 flu immunization campaign, and a hypothetical one, which provides an increase in the market share of the QIV. The Budget Impact Analysis (BIA) considered the following input data.  Population of the province of Viterbo.  Distribution of 60.000 doses of vaccine between TIV and QIV epidemiology of influenza in Italy; efficacy of QIV vs TIV  Direct influenza costs.  Probability to require medical care for complications or hospitalization and related costs. The analysis considered a single-year time frame due to the seasonality of the influenza immunization campaign. Results: In the current scenario, if 35.0000 subjects are vaccinated with QIV, this will result in 1.801 cases among those vaccinated, 1.527 with complications, 176 of which will require hospitalization. In the hypothetical scenario, if 40.000 subjects were vaccinated with QIV, which is the 68 % of target population, 1.478 subjects will get sick, 1259 of which with complications and among them, 145 will be hospitalized. Therefore, the 10 % increase of QIV vaccine, would avoid 322 cases of influenza, of which 268 with complications and 31 hospitalizations. The ASL of Viterbo, thanks to a wider protection of the QIV versus TIV, would have a budget impact of -116.468 Euro. Infect, the cost sustained for the purchase of the vaccine, although increased by 2 % in comparison to the actual scenario, it is compensated by the savings originated by avoided cases of influenza, complications connected to influenza and hospitalization. Conclusion: From the preliminary analysis of the data, concentrating on the exclusive costs of purchase of the vaccines, it is evident that the increase of QIV’s quota market involves an increase of the costs, due to the greatest price of purchase, but overcoming the problematic match-mismatch of the lineage B, produces a saving of 116.468 euros. The study considered the doses of vaccine actually purchased for the influenza campaign in 2015-2016 but did not analyze age groups or administration to risk categories because the data was not available. The results obtained vary by modifying the vaccine’s method of administration and the division of market shares, while maintaining the same number of doses purchased. The data can therefore be considered preliminary and to be verified on the field.
Keywords: Public Health; Influenza Research; WHO; Clinical Demonstrations
