Age- and risk-related appropriateness of the use of available influenza vaccines in the Italian elderly is advantageous: results from a budget impact analysis


Introduction. Nowadays, four different types of influenza vaccines are available in Italy: trivalent (TIV), quadrivalent (QIV), MF59-adjuvanted (aTIV) and TIV (idTIV) inactivated vaccines. Recently, a concept of the appropriateness (i.e. according to the age and risk factors) of the use of different vaccines has been established in Italy. We conducted a budget impact analysis of switching to a policy, in which the Italian elderly (who carry the major disease burden) received the available vaccines according to their age and risk profile.

Methods. A novel budget impact model was constructed with a time horizon of one influenza season. In the reference scenario the cohort of Italian elderly could receive either available vaccine according to 2017/18 season market share. The alternative scenario envisaged the administration of TIV/QIV to people aged 65–74 years at low risk of developing influenza-related complications, while aTIV/idTIV were allocated to high-risk 65–74-year-olds and all subjects aged ≥75 years.

Results. Switching to the alternative scenario would determine both significant health benefits and net budget savings. Particularly, it would be possible to prevent additional 8,201 cases of laboratory-confirmed influenza, 988 complications, 355 hospitalizations and 14 deaths. Despite the alternative strategy would be associated with a slightly higher vaccination costs, the total savings derived from fewer influenza events completely reset this increase with net budget savings of 0.13 million.

Conclusions. The immunization policy in which influenza vaccines are administered according to the age and risk profile of the Italian elderly is advisable.