High-Dose Flu Vaccine Makes Economic Sense for Older Adults

A new economic analysis finds that a high-dose flu vaccine was not only more effective than the standard-dose formulation for preventing influenza in adults age 65 and older but also saved an average of $116 per person in medical costs. The findings appear in the online The Lancet Infectious Diseases (doi:10.1016/S1473-3099(15)00249-2; published online September 8, 2015).

“High-dose trivalent inactivated influenza vaccine is a less costly and more effective alternative to the standard-dose vaccine, driven by a reduction in the number of hospital admissions,” the authors wrote.

The new analysis was based on data from a multi-center efficacy trial involving 31,989 older adults that found the high-dose split-virus inactivated influenza vaccine (IIV-HD, Fluzone High-Dose vaccine, Sanofi Pasteur) better protected older adults from influenza than did the standard-dose split-virus inactivated influenza vaccine (IIV-SD, Fluzone vaccine, Sanofi Pasteur). Those findings were previously published in the New England Journal of Medicine (2014; 371:635-645).

For this study, researchers looked at US health care costs associated with each vaccine as well as participants’ health care use and hospitalizations 6- to 8-months post-vaccination—including medications, emergency department and urgent care visits, and hospitalizations 30 days after any respiratory illness. 

Among older adults who received the high-dose vaccine, healthcare costs averaged $1376.72 per person, versus $1492.64 per person for participants who received the standard-dose vaccine, according to the study. Average societal costs in the high-dose group were lower, too, at $1506.48 per person, compared with $1634.50  per person in the standard-dose group.

Because hospital admissions accounted for 95% of medical costs, a lower rate of hospital admissions in older adults receiving the high-dose vaccine played a major role in the cost savings. The average number of hospital admissions per participant was 0.0937 in the high-dose group and 0.1017 in the standard-dose group, researchers found.

Older adults who received the high-dose vaccine also had a greater gain in quality-adjusted life years (QALY) than those who received the standard-dose vaccine. Per participant, the high-dose vaccine was associated with an additional 8.1502 QALY, compared with 8.1499 additional QALY associated with the standard-dose vaccine.

Explained the researchers, “The probabilistic sensitivity analysis showed that the high-dose vaccine is 93% likely to be cost saving.”

The study did not include residents of nursing homes, noted lead author of the study Ayman Chit, PhD, Sanofi Pasteur, in a blog post on MedicalResearch.com (https://bit.ly/1M3OA3f). He recommended that future research focus on that patient population and other populations that are eligible for the high-dose flu vaccine but not included in the current study.—Jolynn Tumolo