국내 65세 이상 인구에서 고용량 3가 인플루엔자 백신의 비용-효과성 분석
Cost-effectiveness Analysis of High-Dose Trivalent Influenza Vaccine in Adults Aged 65 Years and Older in Korea
Background: As Korea transitions into a super-aged society, preventing influenza and its complications in older adults is essential to reduce morbidity, mortality, and healthcare costs. This study evaluated the cost-effectiveness of high-dose trivalent influenza vaccine (HD-TIV) versus MF59-adjuvanted trivalent influenza vaccine (aTIV) in adults aged ≥65 years, in line with updated WHO recommendations. Methods: A decision-tree model was developed from the Korean healthcare payer perspective to compare HD-TIVs and aTIVs under two scenarios: respiratory events and cardio-respiratory events. Relative vaccine effectiveness (rVE) was derived from randomized controlled trials comparing each vaccine with standard-dose TIVs. The model estimated lifetime direct medical costs, quality-adjusted life years (QALYs), and life years (LYs). Deterministic (DSA) and probabilistic sensitivity analyses (PSA) were performed to assess uncertainty. Results: HD-TIV was cost-effective across all scenarios and age groups. In adults aged ≥65 years, the ICER for the cardio-respiratory scenario was KRW 5.42 million per QALY, well below willingness-to-pay thresholds. Assuming an aTIV price of KRW 30,000, the cost-effective ceiling price for HD-TIV exceeded twice that of aTIV. Among those aged ≥75 years, higher efficacy of HD-TIV (rVE 32.4%) translated into 14,760 fewer hospitalizations, with an ICER of KRW 1.47 million per QALY, confirming robust cost-effectiveness even at prices up to approximately seven times that of aTIV. Conclusions: HD-TIV demonstrates consistent cost-effectiveness compared with aTIV in Korean older adults and may improve individual outcomes while reducing healthcare utilization and alleviating the broader public health and economic burden of influenza.
목차
ABSTRACT 연구 방법 모형 구조와 분석기간 분석대상 인구집단 모형의 가정 결과 고찰 결론 이해 상충 References