Cost-effectiveness of alternative strategies for annual influenza vaccination among children aged 6 months to 14 years in four provinces in China

Lei Zhou; Sujian Situ; Zijian Feng; Charisma Y Atkins; Isaac Chun-Hai Fung; Zhen Xu; Ting Huang; Shixiong Hu; Xianjun Wang; Martin I Meltzer

doi:10.1371/journal.pone.0087590

Cost-effectiveness of alternative strategies for annual influenza vaccination among children aged 6 months to 14 years in four provinces in China

PLoS One. 2014 Jan 31;9(1):e87590. doi: 10.1371/journal.pone.0087590. eCollection 2014.

Authors

Lei Zhou¹, Sujian Situ², Zijian Feng¹, Charisma Y Atkins³, Isaac Chun-Hai Fung⁴, Zhen Xu⁵, Ting Huang⁶, Shixiong Hu⁷, Xianjun Wang⁸, Martin I Meltzer³

Affiliations

¹ Public Health Emergency Center, Chinese Center for Disease Control and Prevention, Beijing, China.
² U.S. Centers for Disease Control and Prevention, Beijing, China.
³ U.S. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Preparedness and Emerging Infections, Atlanta, Georgia, United States of America.
⁴ U.S. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Preparedness and Emerging Infections, Atlanta, Georgia, United States of America ; Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, United States of America.
⁵ Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
⁶ Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China.
⁷ Hunan Center for Disease Control and Prevention, Changsha, Hunan, China.
⁸ Shandong Center for Disease Control and Prevention, Jinan, Shandong, China.

Abstract

Background: To support policy making, we developed an initial model to assess the cost-effectiveness of potential strategies to increase influenza vaccination rates among children in China.

Methods: We studied on children aged 6 months to 14 years in four provinces (Shandong, Henan, Hunan, and Sichuan), with a health care system perspective. We used data from 2005/6 to 2010/11, excluding 2009/10. Costs are reported in 2010 U.S. dollars.

Results: In comparison with no vaccination, the mean (range) of Medically Attended Cases averted by the current self-payment policy for the two age groups (6 to 59 months and 60 months to 14 years) was 1,465 (23 ∼ 11,132) and 792 (36 ∼ 4,247), and the cost effectiveness ratios were $ 0 (-11-51) and $ 37 (6-125) per case adverted, respectively. In comparison with the current policy, the incremental cost effectiveness ratio (ICER) of alternative strategies, OPTION One-reminder and OPTION Two-comprehensive package, decreased as vaccination rate increased. The ICER for children aged 6 to 59 months was lower than that for children aged 60 months to 14 years.

Conclusions: The model is a useful tool in identifying elements for evaluating vaccination strategies. However, more data are needed to produce more accurate cost-effectiveness estimates of potential vaccination policies.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Child, Preschool
China
Costs and Cost Analysis
Female
Humans
Infant
Influenza Vaccines / administration & dosage
Influenza Vaccines / economics*
Male
Mass Vaccination / economics*
Mass Vaccination / methods*
Models, Economic*
Prospective Studies

Substances

Influenza Vaccines

Grants and funding

This study was supported by the China-U.S. Collaborative Program on Emerging and Re-emerging Infectious Diseases. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.