Cost-effectiveness of a recommendation of universal mass vaccination for seasonal influenza in the United States
Journal article
Clements, Karen M., Chancellor, Jeremy, Nichol, Kristin, DeLong, Kelly and Thompson, David. (2011). Cost-effectiveness of a recommendation of universal mass vaccination for seasonal influenza in the United States. Value in Health. https://doi.org/10.1016/j.jval.2011.03.005
Authors | Clements, Karen M., Chancellor, Jeremy, Nichol, Kristin, DeLong, Kelly and Thompson, David |
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Abstract | Objectives: We evaluated the cost-effectiveness of universal mass vaccination (UMV) against influenza compared with a targeted vaccine program (TVP) for selected age and risk groups in the United States. Methods: We modeled costs and outcomes of seasonal influenza with UMV and TVP, taking a societal perspective. The US population was stratified to model age-specific ( < 5, 5–17, 18–49, 50–64, and 65+ years) vaccine coverage and efficacy. Probability of influenza-related illness (ILI) and complications, health-care utilization, costs, and survival were estimated. For a season's intervention, ILI cases in that year, lifetime costs (2008 US$), and quality-adjusted life years (QALYs) lost (both discounted at 3% per annum) were calculated for each policy and used to derive incremental cost-effectiveness ratios. A range of sensitivity and alternative-scenario analyses were conducted. Results: In base-case analyses, TVP resulted in 63 million ILI cases, 859,000 QALYs lost, and $114.5 billion in direct and indirect costs; corresponding estimates for UMV were 61 million cases, 825,000 QALYs lost, and $111.4 billion. UMV was therefore estimated to dominate TVP, saving $3.1 billion and 34,000 QALYs. In probabilistic sensitivity analyses, UMV was dominant in 82% and dominated in 0% of iterations. In alternative-scenario analyses, UMV dominated TVP when lower estimates of vaccine coverage were used. Lower estimates of ILI risk among unvaccinated, vaccine effectiveness, and risk of complications resulted in ICERs of $2800, $8100, and $15,900 per QALY gained, respectively, for UMV compared with TVP. Conclusions: UMV against seasonal influenza is cost saving in the United States under reasonable assumptions for coverage, cost, and efficacy. |
Keywords | cost-effectiveness analysis; influenza vaccination |
Year | 2011 |
Journal | Value in Health |
Publisher | Blackwell Publishing Inc. |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.jval.2011.03.005 |
Publisher's version | File Access Level Controlled |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/8v11w/cost-effectiveness-of-a-recommendation-of-universal-mass-vaccination-for-seasonal-influenza-in-the-united-states
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