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Influenza vaccine

PBAC's latest decision on Influenza vaccine: Not recommended (2007). Considered for extension of National Immunisation Program (NIP) to include influenza vaccination for all Australians aged 50 years and older.

PBAC outcome
Not recommended
2007
ICER (AUD/QALY)
$45k/QALY
Range: $15k/QALY–$45k/QALY
Submissions
1
first 2007
Submissions
1
2007 → 2007
Therapy area
Other
Evidence base
RCT, Meta-analysis
Primary endpoint
ILI, serologically confirmed influenza, hospitalisations
Key trials
Abadoglu et al, Allsup et al, Bridges et al, Cohen et al, Edwards et al, Govaert et al, Mesa Duque et al, Miller et al, Mixeu et al, Musto et al, Nichol et al, Powers et al, Praditsuwan et al, Weingarten et al, Wilde et al, Wongsurakiat et al
Comparator
current influenza vaccination practice in persons aged 50–64 years (including influenza vaccination through the PBS, private prescribing and leakage through the NIP)
Economic model
CUA
ICER note
Base case modelled incremental discounted cost/extra discounted QALY less than $15,000, increasing to $15,000–$45,000 using Jefferson (2007) Cochrane review values. High sensitivity detected.

Why PBAC said no

Reasons cited in the latest PSD: Uncertainty in clinical benefits in terms of hospitalisation and mortality, insufficiently substantiated assumption that 68% reduction in laboratory-confirmed influenza cases leads to 68% reduction in hospitalisation and deaths, lack of inclusion of decrement of vaccine response with age, high sensitivity of cost per QALY to model assumptions, no difference in hospitalisations or deaths between vaccinated and unvaccinated individuals when high-risk patients excluded from meta-analyses
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