Using HTA to lead decision on the use of adjuvanted trivalent inactivated influenza vaccine in Italy [Oral Presentation]

Background There are few Health Technology Assessment (HTA) reports on influenza vaccination available in Italy, none of which evaluated the adjuvanted trivalent inactivated vaccine (aTIV) specifically developed to protect older adults (65 years). aTIV has been used for a long time, but a current assessment is worthwhile because of the availability of new influenza vaccines and new data on the epidemiology of disease and vaccine efficacy. Methods The HTA approach was used to analyze epidemiological, clinical, economic, organizational and ethical aspects of aTIV use in older adults. Alongside aTIV, three other influenza vaccines are used to immunize older adults in Italy: standard trivalent (TIV), intradermal (idTIV), and quadrivalent (QIV); these were considered as comparators. To write the report, an in-depth analysis of Italian surveillance data, and a comprehensive literature review on the burden of disease and vaccine effectiveness were carried out. Furthermore, a model was developed to perform a cost-utility analysis, taking into consideration Italian costs and setting the threshold for costeffectiveness at E30,000/quality-adjusted life year. Results Analysis showed that the epidemiological and virological features of influenza are highly age-dependent. Despite the elderly having the lowest attack rate (on average 5%; laboratory-confirmed diagnoses), the burden of disease in older adults is disproportionately high. 74–95% of all flurelated deaths occur among older adults, and 12.6% of elderly individuals may develop influenza-related complications. Compared to non-adjuvanted vaccines, aTIV has an acceptable safety profile, is more immunogenic, and has higher effectiveness. The cost-utility analysis showed that aTIV is highly costeffective compared with TIV vaccines, and cost-saving compared with idTIV and QIV. Conclusions This report – comprised of the most up to date data – reveals that aTIV should be considered the vaccine of choice for older adults. Key messages: Health Technology Assessment should be used to reassess health technologies when new data become available or new alternatives enter the market. This Health Technology Assessment report on the adjuvanted trivalent inactivated vaccine provides robust evidence that the latter may be considered the vaccine of choice in the elderly population.