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Dolk FCK, de Boer PT, Nagy L, Donker GA, Meijer A, Postma MJ, Pitman R. Consultations for Influenza-Like Illness in Primary Care in The Netherlands: A Regression Approach. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:11-18. [PMID: 33431142 DOI: 10.1016/j.jval.2020.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To estimate the general practitioner (GP) consultation rate attributable to influenza in The Netherlands. METHODS Regression analysis was performed on the weekly numbers of influenza-like illness (ILI) GP consultations and laboratory reports for influenza virus types A and B and 8 other pathogens over the period 2003-2014 (11 influenza seasons; week 40-20 of the following year). RESULTS In an average influenza season, 27% and 11% of ILI GP consultations were attributed to infection by influenza virus types A and B, respectively. Influenza is therefore responsible for approximately 107 000 GP consultations (651/100 000) each year in The Netherlands. GP consultation rates associated with influenza infection were highest in children under 5 years of age, at 667 of 100 000 for influenza A and 258 of 100 000 for influenza B. Influenza virus infection was found to be the predominant cause of ILI-related GP visits in all age groups except children under 5, in which respiratory syncytial virus (RSV) infection was found to be the main contributor. CONCLUSIONS The burden of influenza in terms of GP consultations is considerable. Overall, influenza is the main contributor to ILI. Although ILI symptoms in children under 5 years of age are most often associated with RSV infection, the majority of visits related to influenza occur among children under 5 years of age.
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Affiliation(s)
- F Christiaan K Dolk
- Unit of Pharmacotherapy, Epidemiology, and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands.
| | - Pieter T de Boer
- Unit of Pharmacotherapy, Epidemiology, and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Lisa Nagy
- ICON Health Economics and Epidemiology, Oxfordshire, UK
| | - Gé A Donker
- NIVEL Primary Care Database - Sentinel Practices, Utrecht, The Netherlands
| | - Adam Meijer
- Centre for Infectious Diseases Research, Diagnostics, and Laboratory Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Maarten J Postma
- Unit of Pharmacotherapy, Epidemiology, and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands; Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands; Department of Economics, Econometrics, and Finance, Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
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Sanapala SR, Seco BMS, Baek JY, Awan SI, Pereira CL, Seeberger PH. Chimeric oligosaccharide conjugate induces opsonic antibodies against Streptococcus pneumoniae serotypes 19A and 19F. Chem Sci 2020; 11:7401-7407. [PMID: 34123020 PMCID: PMC8159444 DOI: 10.1039/d0sc02230f] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Streptococcus pneumoniae 19A (ST19A) and 19F (ST19F) are among the prevalent serotypes causing pneumococcal disease worldwide even after introduction of a 13-valent pneumococcal conjugate vaccine (PCV13). Synthetic glycoconjugate vaccines have defined chemical structures rather than isolated polysaccharide mixtures utilized in marketed vaccines. Ideally, a minimal number of synthetic antigens would cover as many bacterial serotypes to lower cost of goods and minimize the response to carrier proteins. To demonstrate that a chimeric oligosaccharide antigen can induce a protective immune response against multiple serotypes, we synthesized a chimeric antigen (ST19AF) that is comprised of a repeating unit of ST19A and ST19F capsular polysaccharide each. Synthetic glycan epitopes representing only ST19A, and ST19F were prepared for comparison. Semisynthetic glycoconjugates containing chimeric antigen ST19AF induced high antibody titers able to recognize native CPS from ST19A and ST19F in rabbits. The antibodies were able to kill both strains of pneumococci. Chimeric antigens are an attractive means to induce an immune response against multiple bacterial serotypes. Chimeric antigens are an attractive means to induce an immune response against multiple bacterial serotypes. The chimeric semisynthetic glycoconjugate ST19AF induced antibodies with opsonic activity able to kill ST19A and ST19F bacteria in rabbits.![]()
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Affiliation(s)
- Someswara Rao Sanapala
- Department of Biomolecular Systems, Max Planck Institute of Colloids and Interfaces Am Mūhlenberg 1 D-14424 Potsdam Germany
| | - Bruna M S Seco
- Department of Biomolecular Systems, Max Planck Institute of Colloids and Interfaces Am Mūhlenberg 1 D-14424 Potsdam Germany .,Department of Chemistry and Biochemistry, Freie Universität Berlin Arnimallee 22 D-14195 Berlin Germany
| | - Ju Yuel Baek
- Department of Biomolecular Systems, Max Planck Institute of Colloids and Interfaces Am Mūhlenberg 1 D-14424 Potsdam Germany
| | - Shahid I Awan
- Department of Biomolecular Systems, Max Planck Institute of Colloids and Interfaces Am Mūhlenberg 1 D-14424 Potsdam Germany
| | - Claney L Pereira
- Department of Chemistry and Biochemistry, Freie Universität Berlin Arnimallee 22 D-14195 Berlin Germany
| | - Peter H Seeberger
- Department of Biomolecular Systems, Max Planck Institute of Colloids and Interfaces Am Mūhlenberg 1 D-14424 Potsdam Germany .,Department of Chemistry and Biochemistry, Freie Universität Berlin Arnimallee 22 D-14195 Berlin Germany
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Crépey P, Redondo E, Díez-Domingo J, Ortiz de Lejarazu R, Martinón-Torres F, Gil de Miguel Á, López-Belmonte JL, Alvarez FP, Bricout H, Solozabal M. From trivalent to quadrivalent influenza vaccines: Public health and economic burden for different immunization strategies in Spain. PLoS One 2020; 15:e0233526. [PMID: 32437476 PMCID: PMC7241783 DOI: 10.1371/journal.pone.0233526] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/06/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Quadrivalent influenza vaccine (QIV) includes the same strains as trivalent influenza vaccine (TIV) plus an additional B strain of the other B lineage. The aim of the study was to analyse the public health and economic impact of replacing TIV with QIV in different scenarios in Spain. METHODS A dynamic transmission model was developed to estimate the number of influenza B cases prevented under TIV and QIV strategies (<65 years (high risk) and ≥65 years). This model considers cross-protective immunity induced by different lineages of influenza B. The output of the transmission model was used as input for a decision tree model that estimated the economic impact of switching TIV to QIV. The models were populated with Spanish data whenever possible. Deterministic univariate and probabilistic multivariate sensitivity analyses were performed. RESULTS Replacing TIV with QIV in all eligible patients with current vaccine coverage in Spain may have prevented 138,707 influenza B cases per season and, therefore avoided 10,748 outpatient visits, 3,179 hospitalizations and 192 deaths. The replacement could save €532,768 in outpatient visit costs, €13 million in hospitalization costs, and €3 million in costs of influenza-related deaths per year. An additional €5 million costs associated with productivity loss could be saved per year, from the societal perspective. The budget impact from societal perspective would be €6.5 million, and the incremental cost-effectiveness ratio (ICER) €1,527 per quality-adjusted life year (QALY). Sensitivity analyses showed robust results. In additional scenarios, QIV also showed an impact at public health level reducing influenza B related cases, outpatient visits, hospitalizations and deaths. CONCLUSIONS Our results show public health and economic benefits for influenza prevention with QIV. It would be an efficient intervention for the Spanish National Health Service with major health benefits especially in the population ≥65-year.
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Affiliation(s)
- Pascal Crépey
- Department of Quantitative Methods in Public Health, UPRES-EA-7449 Reperes, EHESP, University of Rennes, Rennes, France
| | - Esther Redondo
- Centro de Salud Internacional Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Javier Díez-Domingo
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Valencia, Spain
| | - Raúl Ortiz de Lejarazu
- Centro Nacional de Gripe de Valladolid, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Federico Martinón-Torres
- Servicio Pediatría, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain
- Grupo de Genética, Infecciones y Vacunas en Pediatría (GENVIP), Instituto de Investigación Sanitaria de Santiago, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Gil de Miguel
- Departamento de Medicina Preventiva y Salud Pública, Universidad Rey Juan Carlos, Madrid, Spain
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López Trigo JA, López Mongil R, Mariano Lázaro A, Mato Chaín G, Moreno Villajos N, Ramos Cordero P. [Seasonal flu vaccination for older people: Evaluation of the quadrivalent vaccine. Positioning report]. Rev Esp Geriatr Gerontol 2018; 53 Suppl 2:185-202. [PMID: 30107941 DOI: 10.1016/j.regg.2018.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 06/22/2018] [Indexed: 01/08/2023]
Abstract
Influenza is a significant health problem, particularly in those persons susceptible to having associated complications, older people, children less than 2 years, patients with chronic diseases, immunocompromised patients, and pregnant women. But influenza also has a large impact on the health system, with an increase in the healthcare demand and a spectacular increase in outpatient visits, overloading the emergency and hospital services. During epidemic outbreaks, the hospital admission rates of people over 65 years are at a maximum, and the mortality notified for the 2017/2018 influenza season was 960 deaths. The seasonal anti-influenza vaccine is the method with a better cost-effective ratio of primary prevention of influenza, reducing associated respiratory diseases, the number of hospital admissions, and deaths in high risk individuals, as well as work absenteeism in adults. In the last few years, influenza B has received little attention in the scientific literature, although in the periods between epidemics influenza B can be one of the main causes of seasonal epidemics, causing considerable morbidity and mortality and an increase in costs. The quadrivalent vaccine has a second-line immunological protection against influenza B, and according to a critical review of the scientific literature, it provides wider protection without affecting immunogenicity of the other three vaccine strains common to the trivalent and tetravalent vaccine. The quadrivalent vaccine is cost-effective in reducing the number of influenza cases, and is always a worthwhile intervention, with a significant cost saving for the health system and for society, by reducing the hospital admission rates and mortality associated with the complications of influenza. Supplement information: This article is part of a supplement entitled 'Seasonal flu vaccination for older people: Evaluation of the quadrivalent vaccine' which is sponsored by Sanofi-Aventis, S.A.
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Affiliation(s)
- José Antonio López Trigo
- Geriatría, Ayuntamiento de Málaga. Presidencia de la Sociedad Española de Geriatría y Gerontología (SEGG), Málaga, España.
| | | | - Alberto Mariano Lázaro
- Medicina Preventiva y Salud Pública, Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España
| | - Gloria Mato Chaín
- Medicina Preventiva y Salud Pública, Unidad de Vacunación del Adulto, Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España
| | | | - Primitivo Ramos Cordero
- Coordinación médico-asistencial, Servicio Regional de Bienestar Social, Comunidad de Madrid, Madrid, España
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de Boer PT, van Maanen BM, Damm O, Ultsch B, Dolk FCK, Crépey P, Pitman R, Wilschut JC, Postma MJ. A systematic review of the health economic consequences of quadrivalent influenza vaccination. Expert Rev Pharmacoecon Outcomes Res 2017; 17:249-265. [PMID: 28613092 DOI: 10.1080/14737167.2017.1343145] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Quadrivalent influenza vaccines (QIVs) contain antigens derived from an additional influenza type B virus as compared with currently used trivalent influenza vaccines (TIVs). This should overcome a potential reduced vaccine protection due to mismatches between TIV and circulating B viruses. In this study, we systematically reviewed the available literature on health economic evaluations of switching from TIV to QIV. Areas covered: The databases of Medline and Embase were searched systematically to identify health economic evaluations of QIV versus TIV published before September 2016.A total of sixteen studies were included, thirteen cost-effectiveness analyses and three cost-comparisons. Expert commentary: Published evidence on the cost-effectiveness of QIV suggests that switching from TIV to QIV would be a valuable intervention from both the public health and economic viewpoint. However, more research seems mandatory. Our main recommendations for future research include: 1) more extensive use of dynamic models in order to estimate the full impact of QIV on influenza transmission including indirect effects, 2) improved availability of data on disease outcomes and costs related to influenza type B viruses, and 3) more research on immunogenicity of natural influenza infection and vaccination, with emphasis on cross-reactivity between different influenza B viruses and duration of protection.
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Affiliation(s)
- Pieter T de Boer
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Britt M van Maanen
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Oliver Damm
- b Department of Health Economics and Health Care Management, School of Public Health , Bielefeld University , Bielefeld , Germany
| | - Bernhard Ultsch
- c Immunisation Unit , Robert Koch Institute , Berlin , Germany
| | - Franklin C K Dolk
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands
| | - Pascal Crépey
- d Department of Quantitative Methods in Public Health , EHESP Rennes , Sorbonne Paris Cité, Rennes , France.,e UPRES-EA-7449 Reperes, University of Rennes 1 , Rennes , France
| | | | - Jan C Wilschut
- g Department of Medical Microbiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Maarten J Postma
- a Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy , University of Groningen , Groningen , The Netherlands.,h Department of Epidemiology , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands.,i Institute of Science in Healthy Aging & healthcaRE (SHARE) , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
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