Cost-effectiveness of routine influenza vaccination program for individuals aged 65 years and older in Japan: Substituting standard-dose inactivated vaccine with high-dose inactivated vaccine
Year: 2026
Type: article
Abstract: Objectives: We evaluated cost-effectiveness of influenza immunization programs for protection of Japanese elderly (aged ≥65 years) from influenza-related diseases by comparing high-dose inactivated influenza vaccine (HD-IIV3) to standard vaccines (SD-IIV3). Methods: Incremental cost-effectiveness ratio (ICER) from payers' perspective was calculated. Variables used in the model were either calculated or extracted from literature. Quality-adjusted life years (QALYs) was used as measure of effectiveness. Cost per dose of HD vaccine was assumed to be four times of SD (JPY 1500/US$ 10). Results: In comparison to SD, HD gained more QALYs and reduced disease treatment costs, but these reduced costs did not offset vaccination cost. ICER for those aged ≥65 years was JPY 7,352,458/ US$ 49,016 per QALY, higher than the willingness-to-pay (WTP) threshold of JPY 5,000,000/US$ 33,333 per QALY. While ICER was JPY 50,477,31/US$ 33,652 for those aged ≥75 years. One-way sensitivity analysis revealed that relative vaccine effect against laboratory-confirmed influenza of HD to SD influenced the ICER the most. Monte Carlo simulations revealed that the probability of an ICER below WTP threshold was 20.9%. Conclusions: For a WTP of JPY 5,000,000/US$ 33,333 per QALY gained, if the price of HD was four times the current vaccine, the seasonal HD-IIV3 vaccination program was not cost-effective for those aged ≥65 years, while was cost-effective for those aged ≥75 years.
Source: IJID Regions
Authors: Shu-ling Hoshi, Xerxes Seposo, Masahide Kondo
Institutions: University of Tsukuba, Hokkaido University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,380
OpenAlex ID: W7128813972