Optimising age coverage of seasonal influenza vaccination in England: A mathematical and health economic evaluation
Fig 5
Threshold price per additional vaccine dose for additional vaccines required to add a low-risk vaccine programme (relative to an at-risk only vaccination programme).
Threshold vaccine dose prices reflect the cost at which 90% of all simulations generate cost-effective results at a WTP of £30,000 per QALY, with 3.5% discounting for monetary costs and health effects. In all strategies we assumed 10% vaccine wastage and an administration fee per deployed vaccine of £10. (a) Paired low-risk programmes (combined young-age centric and elder-age centric coverage). Shading transitioning from dark shading to light shading depicts shifts from low to high prices. The white region corresponds to omitted strategies, where young-age centric and elder-age centric coverage would overlap. The red cross marks the coverage offered by the current seasonal influenza vaccine policy for England. (b) Addition of a low-risk young-age centric programme only. (c) Addition of a low-risk elder-age centric programme only. (d) Cost-effectiveness assessments of incrementally expanding paired low-risk vaccine programmes. Vertical arrows denote incremental expansions of the elder-age centric component (e.g. going from 70-100+yrs to 68-100+yrs) of a paired vaccination programme that were evaluated as cost-effective. Similarly, horizontal arrows denote incremental expansions of the young-age centric component (e.g. going from 2-10yrs to 2-12yrs) of a paired vaccination programme that were evaluated as cost-effective. The colour of the arrow distinguishes willingness to pay values per vaccine dose that were less than £5 (red) or £5 and above (black). The green box contains the assessment of incremental expansion from the current low-risk coverage offered by the seasonal influenza vaccine policy for England.