Cost-benefit analysis of a quadrivalent influenza vaccine in India

In India, influenza presents a significant burden of disease to the population at large. Influenza vaccination is a cost-effective means of preventing the disease, with quadrivalent vaccines providing broader protection against influenza by covering more strains, but generally at a higher list price, than older trivalent vaccines. Broadly, the economic burden of influenza can be categorized into treatment and productivity costs. We undertake a cost-benefit analysis to determine the cost-effectiveness of a quadrivalent influenza vaccine versus no vaccination amongst healthy adults and pregnant women from the perspective of both employers and the Employees’ State Insurance Company (ESIC) in India. Administration of the quadrivalent vaccine results in better outcomes in terms of productive days worked and disease infection rates amongst the target populations whilst incurring lower overall health resource utilization costs than when no vaccine is employed. In healthy adults, we estimate a saving of INR 13,730 per case averted from the corporate perspective and a saving of INR 11,211 from the ESIC perspective. Deterministic and probabilistic sensitivity analyses indicate that there is a high probability that these results hold true given the uncertainty in our model’s input parameters. We find that for healthy adults and pregnant women, receiving a quadrivalent influenza vaccine is dominant over no vaccination in terms of cost-effectiveness that is, it results in better health outcomes at a lower overall cost.