Influenza vaccines in low and middle income countries A systematic review of economic evaluations

J.J. Ott, J. Klein Breteler, J.S. Tam, R.C.W. Hutubessy, M.R. de Boer

Research output: Contribution to JournalArticleAcademicpeer-review


Objectives: Economic evaluations on influenza vaccination from low resource settings are scarce and have not been evaluated using a systematic approach. Our objective was to conduct a systematic review on the value for money of influenza vaccination in low- and middle-income countries. Methods: PubMed and EMBASE were searched for economic evaluations published in any language between 1960 and 2011. Main outcome measures were costs per influenza outcome averted, costs per quality-adjusted life years gained or disability-adjusted life years averted, costs per benefit in monetary units or cost-benefit ratios. Results: Nine economic evaluations on seasonal influenza vaccine met the inclusion criteria. These were model- or randomized-controlled-trial (RCT)-based economic evaluations from middle-income countries. Influenza vaccination provided value for money for elderly, infants, adults and children with high-risk conditions. Vaccination was cost-effective and costsaving for chronic obstructive pulmonary disease patients and in elderly above 65 y from model-based evaluations, but conclusions from RCTs on elderly varied. Conclusion: Economic evaluations from middle income regions differed in population studied, outcomes and definitions used. Most findings are in line with evidence from high-income countries highlighting that influenza vaccine is likely to provide value for money. However, serious methodological limitations do not allow drawing conclusions on cost-effectiveness of influenza vaccination in middle income countries. Evidence on cost-effectiveness from low-income countries is lacking altogether, and more information is needed from full economic evaluations that are conducted in a standardized manner. © 2013 Landes Bioscience.
Original languageEnglish
Pages (from-to)1500-1511
JournalHuman Vaccines & Immunotherapeutics
Issue number7
Publication statusPublished - 2013


Dive into the research topics of 'Influenza vaccines in low and middle income countries A systematic review of economic evaluations'. Together they form a unique fingerprint.

Cite this