Cost-effectiveness and public health impact of influenza vaccination strategies for Chinese patients with rheumatoid arthritis

Patients with rheumatoid arthritis (RA) are at higher risk of influenza than the general population, and influenza vaccination can effectively prevent infection in this group. We assessed the cost‑effectiveness of influenza vaccination for individuals with RA in China. We used a Markov model to project outcomes for several vaccination scenarios in hypothetical Chinese RA cohorts over five years. We quantified cases and deaths averted, quality‑adjusted life‑years (QALYs) gained, and incremental cost‑effectiveness ratios (ICERs) to identify the optimal vaccination strategy. Deterministic and probabilistic sensitivity analyses were conducted to assess model uncertainty. Compared with no vaccination, annual coverage levels of 2%, 30%, 60%, and 80% increased costs by US$230, US$165, US$96, and US$50 and yielded 0.006, 0.098, 0.198, and 0.064 additional QALYs, respectively. At 30% coverage, vaccination averted 203,199 influenza cases and yielded 0.49 million additional QALYs relative to no vaccination. Our findings remained robust across all sensitivity analyses. Influenza vaccination among RA patients in China was cost‑effective, with ICERs of US$38,312, US$1,687, US$486, and US$190 at coverage rates of 2%, 30%, 60%, and 80%, respectively. Increasing influenza vaccine coverage among individuals with RA is strongly recommended.