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Peer-reviewedCC BY-NC 4.0Human Vaccines & Immunotherapeutics

Cost-effectiveness of recombinant influenza vaccine compared with standard-dose influenza vaccine among adults 50 years of age and older in Hong Kong

  • Shuyi Zhong1
  • Irene O. L. Wong1
  • Peng Wu1
  • Benjamin J. Cowling1
  1. 1World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, Pokfulam, China
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Abstract

Older adults face a disproportionately high risk of severe influenza, yet the standard inactivated influenza vaccine (IIV) offers suboptimal protection in this population. This study evaluates the cost-effectiveness of replacing IIV with the recombinant influenza vaccine (RIV) for adults aged ≥50, ≥65, and ≥80 years in Hong Kong. We used a decision tree model to compare RIV with IIV for adults aged ≥50, ≥65, and ≥80 years in Hong Kong, from a societal perspective. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were evaluated, and the impact of parameter uncertainty on the results was assessed via deterministic and probabilistic sensitivity analyses. We found that for adults ≥ 50 years, RIV increased total costs by USD 5.1 (HKD 39.8) per person and gained 0.00012 QALYs (ICER: USD 40,659 [HKD 317,140] per QALY) compared with IIV. Among adults ≥65 years, RIV cost USD 6.0 (HKD 46.8) more and gained 0.00021 QALYs (ICER: USD 29,077 [HKD 226,801] per QALY). For adults ≥80 years, RIV cost USD 3.2 (HKD 25.0) more and gained 0.00015 QALYs (ICER: USD 21,092 [HKD 164,518] per QALY). ICERs were less than willingness-to-pay thresholds of one to three times Hong Kong’s gross domestic product per capita. In conclusion, RIV is cost-effective compared with IIV for adults ≥50, ≥65, and ≥80 years in Hong Kong, with the lowest ICER observed in individuals ≥80 years.

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Cite

BibTeXRIS
BibTeX
@article{zhong2026costeffectiveness,
  title = {{Cost-effectiveness of recombinant influenza vaccine compared with standard-dose influenza vaccine among adults 50 years of age and older in Hong Kong}},
  author = {Shuyi Zhong and Irene O. L. Wong and Peng Wu and Benjamin J. Cowling},
  journal = {Human Vaccines \& Immunotherapeutics},
  year = {2026},
  month = nov,
  doi = {10.1080/21645515.2026.2757415},
  url = {https://doi.org/10.1080/21645515.2026.2757415},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Cost-effectiveness of recombinant influenza vaccine compared with standard-dose influenza vaccine among adults 50 years of age and older in Hong Kong
AU  - Shuyi Zhong
AU  - Irene O. L. Wong
AU  - Peng Wu
AU  - Benjamin J. Cowling
PY  - 2026
DA  - 2026/11/02
JO  - Human Vaccines & Immunotherapeutics
DO  - 10.1080/21645515.2026.2757415
UR  - https://doi.org/10.1080/21645515.2026.2757415
AB  - Older adults face a disproportionately high risk of severe influenza, yet the standard inactivated influenza vaccine (IIV) offers suboptimal protection in this population. This study evaluates the cost-effectiveness of replacing IIV with the recombinant influenza vaccine (RIV) for adults aged ≥50, ≥65, and ≥80 years in Hong Kong. We used a decision tree model to compare RIV with IIV for adults aged ≥50, ≥65, and ≥80 years in Hong Kong, from a societal perspective. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were evaluated, and the impact of parameter uncertainty on the results was assessed via deterministic and probabilistic sensitivity analyses. We found that for adults ≥ 50 years, RIV increased total costs by USD 5.1 (HKD 39.8) per person and gained 0.00012 QALYs (ICER: USD 40,659 [HKD 317,140] per QALY) compared with IIV. Among adults ≥65 years, RIV cost USD 6.0 (HKD 46.8) more and gained 0.00021 QALYs (ICER: USD 29,077 [HKD 226,801] per QALY). For adults ≥80 years, RIV cost USD 3.2 (HKD 25.0) more and gained 0.00015 QALYs (ICER: USD 21,092 [HKD 164,518] per QALY). ICERs were less than willingness-to-pay thresholds of one to three times Hong Kong’s gross domestic product per capita. In conclusion, RIV is cost-effective compared with IIV for adults ≥50, ≥65, and ≥80 years in Hong Kong, with the lowest ICER observed in individuals ≥80 years.
SN  - 2164-5515
SN  - 2164-554X
ER  -