Inclusion Of Safety/ADR-Related Outcomes In Economic Evaluations For Seasonal Influenza Vaccines: A Review Of Available Studies

T. Fens, B.M. Van Maanen, P.T. De Boer, E.P. Van Puijenbroek, M.J. Postma

Research output: Contribution to journalMeeting AbstractAcademic


Objectives: In this study we assessed how economic evaluations (EE) on seasonal influenza vaccines include Adverse Drug Reactions (ADRs) and what the impact of its inclusion on the health economic outcomes would be. MethOds: We searched MEDLINE, EMBASE and The Cochrane Library to identify full-text published studies in peer-reviewed journals. Full EEs on seasonal influenza vaccines, discussing ADR-related outcomes, published in any language up to December 5th 2016 were considered as eligible. The protocol for this review was published in PROSPERO. Results: Forty-nine EEs included ADR-related parameters, apparently reflecting approximately 25% of EE-papers in the initial search. Notably, ADR-related costs included the direct medical costs of ADRs management, physician visit, hospitalizations and medication/treatment in 44 articles, and broader costs of time loss seeking treatment for ADRs, caregiver time, productivity loss/work absenteeism, traveling fee and household costs in 13 articles. Furthermore, ADR-related disutility/QALY were considered in 18 articles with explicit specification of duration and frequency of health losses. The most commonly included ADR was the Guillain-Barré syndrome. In those papers that allowed such estimation, direct costs of ADRs reflected less than 1% of total direct costs. Most studies specified a cost-effectiveness analysis design from the societal perspective. Mainly the EEs were comparing influenza vaccination with no vaccination (34 articles). Analyses on children were most frequent (18), followed by analyses over elderly (10), pregnant/postpartum woman and infants (7), and other groups of adults (risk groups, workforce). Data on the costs and health impacts of ADRs were derived from public databases (costs), population-based studies and surveys (utilities/QALYs) and clinical trials (frequencies). cOnclusiOns: Seemingly, the majority of influenza vaccine EEs do not include potential ADRs of the influenza vaccine. Of those studies that allow such estimation, costs of included ADRs are very modest.
Original languageEnglish
Article numberPIN50
Pages (from-to)A787
Number of pages1
JournalValue in Health
Issue number9
Publication statusPublished - Oct-2017


  • influenza vaccine
  • absenteeism
  • adult
  • adverse drug reaction
  • aged
  • caregiver
  • child
  • clinical trial (topic)
  • Cochrane Library
  • cost effectiveness analysis
  • Embase
  • female
  • high risk population
  • hospitalization
  • household
  • human
  • infant
  • influenza vaccination
  • language
  • Medline
  • pharmacokinetics
  • physician
  • pregnancy
  • quality adjusted life year
  • seasonal influenza
  • side effect
  • syndrome
  • systematic review
  • travel

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