Trabajos Publicados

Cost-Effectiveness Analysis of Switching from Trivalent to Quadrivalent Seasonal Influenza Vaccine in Argentina

2022-01-01T00:00:00Z

Cost-Effectiveness Analysis of Switching from Trivalent to Quadrivalent Seasonal Influenza Vaccine in Argentina Urueña, Analía; Micone, Paula; Magneres, María Cecilia; Mould-Quevedo, Joaquín; Giglio, Norberto The burden of seasonal influenza disease in Argentina is considerable. The cost-effectiveness of trivalent (TIV) versus quadrivalent influenza vaccine (QIV) in Argentina was assessed. An age-stratified, static, decision-tree model compared the costs and benefits of vaccination for an average influenza season. Main outcomes included: numbers of influenza cases; general practitioner (GP) visits; complicated ambulatory cases; hospitalizations; deaths averted; and costs per quality-adjusted life years (QALYs) gained. Epidemiological data from Argentina for 2014–2019 were used to determine the proportion of A and B strain cases, and the frequency of mismatch between vaccine and circulating B strains. To manage uncertainty, one-way and probabilistic sensitivity analyses were performed. Switching from TIV to QIV would prevent 19,128 influenza cases, 16,164 GP visits, 2440 complicated ambulatory cases, 524 hospitalizations, and 82 deaths. Incremental cost–effectiveness ratios (ICERs) per QALY were 13,590 and 11,678 USD from the payer’s and societal perspectives, respectively. The greatest health benefits and direct medical cost savings would occur in ≥ 65-year-olds. One-way sensitivity analyses demonstrated the principal drivers of ICER to be vaccine acquisition costs, environmental B strain predominance, and B strain mismatch. Introducing QIV in Argentina would be beneficial and cost-effective relative to TIV, particularly in older adults.

Cost-Effectiveness Analysis of Cell Versus Egg-Based Seasonal Influenza Vaccination in Children and Adults in Argentina

2022-01-01T00:00:00Z

Cost-Effectiveness Analysis of Cell Versus Egg-Based Seasonal Influenza Vaccination in Children and Adults in Argentina Urueña, Analía; Micone, Paula; Magneres, María Cecilia; McGovern, Ian; Mould-Quevedo, Joaquín; Rocha Sarmento, Túlio Tadeu; Giglio, Norberto Background: Quadrivalent cell-based influenza vaccines (QIVc) avoid egg-adaptive mutations and can be more effective than traditional quadrivalent egg-based influenza vaccines (QIVe). This analysis compared the cost-effectiveness of QIVc and QIVe in Argentinian populations < 65 years old from the payer and societal perspectives. Methods: A static decision tree model compared the costs and health benefits of vaccination with QIVc vs. QIVe using a one-year time horizon. The relative vaccine effectiveness of QIVc vs. QIVe was assumed to be 8.1% for children and 11.4% for adults. An alternative high egg-adaptation scenario was also assessed. Model inputs were sourced from Argentina or the international literature. Deterministic and probabilistic sensitivity analyses were performed. Results: Compared to QIVe, QIVc would prevent 17,857 general practitioner visits, 2418 complications, 816 hospitalizations, and 12 deaths per year. From the payers’ perspective, the incremental cost-effectiveness ratio per quality-adjusted life years gained was USD12,214 in the base case and USD2311 in the high egg-adaptation scenario. QIVc was cost-saving from the societal perspective in both scenarios. Conclusions: QIVc in Argentina would be cost-effective relative to QIVe. The potential health benefits and savings would be even higher in high egg-adaptation seasons.

Real-World Evidence in Cost-Effectiveness Analysis of Enhanced Influenza Vaccines in Adults ≥ 65 Years of Age: Literature Review and Expert Opinion

2023-01-01T00:00:00Z

Real-World Evidence in Cost-Effectiveness Analysis of Enhanced Influenza Vaccines in Adults ≥ 65 Years of Age: Literature Review and Expert Opinion Postma, Maarten; Fisman, David; Giglio, Roberto; Márquez-Peláez, Sergio; Nguyen, Van Hung; Pugliese, Andrea; Ruíz-Aragón, Jesús; Urueña, Analía; Mould-Quevedo, Joaquín Influenza vaccination can benefit most populations, including adults ≥ 65 years of age, who are at greater risk of influenza-related complications. In many countries, enhanced vaccines, such as adjuvanted, high-dose, and recombinant trivalent/quadrivalent influenza vaccines (aTIV/aQIV, HD-TIV/HD-QIV, and QIVr, respectively), are recommended in older populations to provide higher immunogenicity and increased relative vaccine efficacy/effectiveness (rVE) than standard-dose vaccines. This review explores how efficacy and effectiveness data from randomized controlled trials and real-world evidence (RWE) are used in economic evaluations. Findings from published cost-effectiveness analyses (CEA) on enhanced influenza vaccines for older adults are summarized, and the assumptions and approaches used in these CEA are assessed alongside discussion of the importance of RWE in CEA. Results from many CEA showed that adjuvanted and high-dose enhanced vaccines were cost-effective compared with standard vaccines, and that differences in rVE estimates and acquisition price may drive differences in cost-effectiveness estimates between enhanced vaccines. Overall, RWE and CEA provide clinical and economic rationale for enhanced vaccine use in people ≥ 65 years of age, an at-risk population with substantial burden of disease. Countries that consider RWE when making vaccine recommendations have preferentially recommended aTIV/aQIV, as well as HD-TIV/HD-QIV and QIVr, to protect older individuals.

Epidemiology of Dengue in Argentina during the 2010/11 to 2019/20 Seasons: A Contribution to the Burden of Disease

2024-01-01T00:00:00Z

Epidemiology of Dengue in Argentina during the 2010/11 to 2019/20 Seasons: A Contribution to the Burden of Disease Rapaport, Solana; Mauriño, Mariana; Morales, María Alejandra; Fabbri, Cintia; Luppo, Victoria; Buyayisqui, María Pía; Varela, Teresa; Giovacchini, Carlos; Urueña, Analía Background: Dengue is an important public health problem in Argentina, as in many other countries. We reviewed and updated information on the dengue disease burden in Argentina over a 10-year period. Methods: We conducted a retrospective descriptive study from 2010 to 2020 based on data from the National Health Surveillance System. The main outcomes included dengue cases, incidence rates, deaths, and serotype distribution by season, age group, and region. Results: A total of 109,998 confirmed cases of dengue were reported. Seasonality stands out, prevailing during summer and autumn. Two main outbreaks (seasons 2015/16 and 2019/20), with increasing magnitude, were observed. The 2019/20 season showed the highest number of cases (58,731) and incidence rate (135/100,000). The Northeast region had the highest number of cases and incidence rate. I n 2020, for the first time, autochthonous cases were registered in the Cuyo region. The only region with no autochthonous cases was the South. Adolescents and young adults showed the highest incidence rate. The case fatality rate for the period was 0.05%. Four serotypes circulated, but the predominant one was DEN-1 (78%). Conclusions: Dengue has been expanding temporally and spatially. Although the DEN-1 serotype widely predominated, the increasing circulation of other serotypes raises concerns regarding re-exposure and the severity of future cases. Understanding epidemiological trends is key to defining public prevention and control policies.