Influenza vaccination for heart failure patients: a cost-effectiveness analysis from the perspective of Chinese healthcare system

Influenza vaccination for heart failure patients: a cost-effectiveness analysis from the perspective of Chinese healthcare system

ORIGINAL RESEARCH article

Front. Public Health

Sec. Health Economics

Volume 12 – 2024 |
doi: 10.3389/fpubh.2024.1348207

This article is part of the Research Topic Impact of COVID-19 Pandemics and Syndemics on Healthcare Systems Worldwide View all 14 articles

Provisionally accepted

  • 1
    Shaanxi University of Science and Technology, Xi’an, Shaanxi, China
  • 2
    Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi Province, China

The final, formatted version of the article will be published soon.

    Purpose: Influenza infection induces cardiovascular events in heart failure (HF) patients, with potential risk reduction through vaccination. This study aims to evaluate the cost-effectiveness of influenza vaccination for HF patients in China.
    Methods: We developed a Markov model with a 3-month cycle to simulate the cost-effectiveness of administering the influenza vaccine to patients with HF over a 3-year period. Patients in the model received either the influenza vaccine or a placebo, in addition to standard HF treatment. Cost data, sourced from the China Healthcare Statistic Yearbook and other public records, and effectiveness data from the IVVE (Influenza Vaccine To Prevent Adverse Vascular Events in HF) trial, were incorporated. Specifically, the cost of the influenza vaccine was 75 Chinese Yuan (CNY) (11 USD), the cost of hospitalization for heart failure (HHF) was 9326 CNY (1386 USD), and the cost of treatment for pneumonia was 5984 CNY (889 USD). The study’s primary outcome, the incremental cost-effectiveness ratio (ICER), quantifies the incremental cost (CNY and USD) per incremental quality-adjusted life year (QALY). Additional outcomes included total cost, total effectiveness, incremental cost, and incremental effectiveness. We conducted one-way and probabilistic sensitivity analyses (PSA) to assess certainty and uncertainty, respectively.
    Results: In the base case analysis, influenza vaccine, compared to placebo, among Chinese HF patients, resulted in a cost increase from 21,004 CNY (3121 USD) to 21,062 CNY (3130 USD) and in QALYs from 1.89 to 1.92 (2.55 life years vs. 2.57 life years) per patient. The resulting ICER was 2331 CNY (346 USD) per QALY (2080 CNY (309 USD) per life year), falling below the willingness-to-pay threshold based on per capita GDP. One-way sensitivity analysis revealed that disparities in HHF and cardiovascular death rates between groups had the most significant impact on the ICER, while the cost of vaccines had a marginal impact. PSA and scenario analysis collectively affirmed the robustness of our findings.
    Conclusion: This study suggests that adding the influenza vaccine to standard treatment regimens for Chinese patients with HF may represent a highly cost-effective option. Further real-world data studies are essential to validate these findings.

    Keywords:
    influenza vaccine, cost-effectiveness analysis, Heart Failure, Cost-utility analysis, influenza infection

    Received:
    02 Dec 2023;
    Accepted:
    23 Jul 2024.

    Copyright:
    © 2024 Zhao, Liu, Wang and Chen. This is an
    open-access article distributed under the terms of the
    Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted,
    provided the original author(s) or licensor are credited and that the
    original publication in this journal is cited, in accordance with accepted
    academic practice. No use, distribution or reproduction is permitted which
    does not comply with these terms.

    * Correspondence:

    Lan Wang, Shaanxi University of Science and Technology, Xi’an, 710021, Shaanxi, China

    Dan Chen, Shaanxi University of Science and Technology, Xi’an, 710021, Shaanxi, China

    Disclaimer:
    All claims expressed in this article are solely those of the authors and
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