WHO Economic Analysis Value Chain of Seasonal Flu Vaccination Programme

Presenter: Heather Fraser

Twitter: '@heatherfraser10

Co-authors: Ijeoma Edoka, Ciaran Kohli-Lynch, Winfrida Mdewa, Cheryl Cohen, Karen Hofman & Raymond Hutubessy

Poster file: [download]
Background: Influenza accounts for a significant number of deaths annually in South Africa. The burden of seasonal influenza is further exacerbated by a high prevalence of HIV and tuberculosis. To address this burden of disease, the South African National Department of Health introduced an influenza vaccination programme in 2010. However, due to budget constraints and competing priorities in other disease areas, coverage remains low among high-risk population groups including children, pregnant women, the elderly, HIV positive individuals and those with other underlying medical conditions. This study aimed to assess the costs and health outcomes associated with the seasonal influenza vaccination programme in South Africa. Methods: This study assesses the costs and cost-effectiveness of the seasonal influenza vaccination programme using two standardised tools recently developed by the WHO – the Seasonal Influenza Immunization Costing Tool, an ingredient-based costing tool; and the Cost-Effectiveness Tool for Seasonal Influenza, a worksheet-based static decision analytic modelling tool, respectively. In addition, this study pilot-tested the two new WHO tools in combination – assessing their flexibility and ease of application in different settings. We estimated total cost (USD 2018) and incremental cost per quality-adjusted life year (QALY) for each high-risk group, and for the overall high-risk population compared to no vaccination, from a health system perspective, employing a 1-year time horizon. Preliminary Results: Minor adaptations to the model structure and target populations were required. Preliminary results show that cost-effectiveness of the South African vaccination programme in the overall population was approximately $4,400/QALY. Preliminary results show that cost-effectiveness varies in the sub-groups from $3,500/QALY (children) to $6,600/QALY (elderly). Discussion: The pilot-testing exercise provides a framework for adaptation and use of the WHO economic analysis value chain toolkit in different healthcare settings. This study provides cost-effectiveness evidence for the seasonal influenza vaccination programme in South Africa, highlighting potential target populations for scale-up.