Influenza Vaccination Implementation in Sri Lanka: A Cost-Effectiveness Analysis.

Neighbors, Coralei E

Myers, Evan R

Weerasinghe, Nayani P

Wijayaratne, Gaya B

Bodinayake, Champica K

Nagahawatte, Ajith

Tillekeratne, L Gayani

Woods, Christopher W

2023-10-18T23:41:43Z

2023-10-18T23:41:43Z

2023-05

2023-10-18T23:41:40Z

Influenza causes an estimated 3 to 5 million cases of severe illness annually, along with substantial morbidity and mortality, particularly in low- and middle-income countries (LMICs). Currently, Sri Lanka has no influenza vaccination policies and does not offer vaccination within the public healthcare sector. Therefore, we performed a cost-effectiveness analysis of influenza vaccine implementation for the Sri Lankan population. We designed a static Markov model that followed a population cohort of Sri Lankans in three age groups, 0-4, 5-64, and 65+ years, through two potential scenarios: trivalent inactivated vaccination (TIV) and no TIV across twelve-monthly cycles using a governmental perspective at the national level. We also performed probabilistic and one-way sensitivity analyses to identify influential variables and account for uncertainty. The vaccination model arm reduced influenza outcomes by 20,710 cases, 438 hospitalizations, and 20 deaths compared to no vaccination in one year. Universal vaccination became cost-effective at approximately 98.01% of Sri Lanka's 2022 GDP per capita (incremental cost-effectiveness ratio = 874,890.55 Rs/DALY averted; 3624.84 USD/DALY averted). Results were most sensitive to the vaccine coverage in the 5-64-year-old age group, the cost of the influenza vaccine dose in the 5-64-years-old age group, vaccine effectiveness in the under-5-years-old age group, and the vaccine coverage in the under-5-years-old age group. No value for a variable within our estimated ranges resulted in ICERs above Rs. 1,300,000 (USD 5386.15) per DALY adverted. Providing influenza vaccines was considered highly cost-effective compared to no vaccines. However, large-scale national studies with improved data are needed to better inform estimates and determine the impact of vaccination implementation.

vaccines11050932

2076-393X

2076-393X

https://hdl.handle.net/10161/29283

eng

MDPI AG

Vaccines

10.3390/vaccines11050932

Markov model

Sri Lanka

cost-effectiveness

economic evaluation

influenza

vaccination

Influenza Vaccination Implementation in Sri Lanka: A Cost-Effectiveness Analysis.

Journal article

Neighbors, Coralei E|0000-0002-0367-2983

Tillekeratne, L Gayani|0000-0001-6012-7271

Woods, Christopher W|0000-0001-7240-2453

932

5

Duke

School of Medicine

Student

Basic Science Departments

Clinical Science Departments

Institutes and Centers

Medicine

Obstetrics and Gynecology

Pathology

Medicine, Infectious Diseases

Duke Cancer Institute

Duke Clinical Research Institute

Duke Human Vaccine Institute

Institutes and Provost's Academic Units

University Institutes and Centers

Duke Global Health Institute

Initiatives

Population Health Sciences

Duke - Margolis Center For Health Policy

Obstetrics and Gynecology, Women's Community & Population Health

Published

11