| مستخلص: |
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 theoretical cohort of Sri Lankans of all ages through two potential scenarios: universal 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 any influential variables and account for uncertainty.The vaccination model arm reduced all influenza outcomes by approximately 60% (170,283 episodes, 3,167 hospitalizations, and 152 deaths) compared to no vaccination. By implementing vaccination earlier in the year, this reduction in the influenza disease burden was maximized. Vaccination was considered cost-effective compared to no vaccination, with a base case incremental cost-effectiveness ratio (ICER) estimated at Rs. 968,071.45 /DALY (5,418.62 USD/DALY). Sensitivity analysis identified that implementation month, monthly probability of contracting influenza, cost of vaccination, and years of life disabled were influential variables. Probabilistic sensitivity analyses identified a 99% probability that vaccination was cost-effective. No value for a variable within our estimated ranges resulted in an ICER above the willingness to pay (WTP) threshold of Rs. 2,066,157 (USD 11,556) per DALY averted.Providing influenza vaccines was considered cost-effective compared to implementing no vaccine, per WHO standard. However, due to a lack of national data, large-scale national studies are needed to determine better the influenza disease burden, at-risk population, and implementation cost |
