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Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis.
Am J Med 2005; 118(1):68-77AJ

Abstract

PURPOSE

To determine the cost-effectiveness of influenza vaccination, antiviral therapy, or no intervention for healthy working adults, accounting for annual variation in vaccine efficacy.

METHODS

We conducted a cost-effectiveness analysis based on published clinical trials of influenza vaccine and antiviral drugs, incorporating 10 years of surveillance data from the World Health Organization. We modeled influenza vaccination, treatment of influenza-like illness with antiviral drugs, or both, as compared with no intervention, targeting healthy working adults under age 50 years in the general community or workplace. Outcomes included costs, illness days, and quality-adjusted days gained.

RESULTS

In the base case analysis, the majority of costs incurred for all strategies were related to lost productivity from influenza illness. The least expensive strategy varied from year to year. For the 10-year period, antiviral therapy without vaccination was associated with the lowest overall costs (234 US dollars per person per year). Annual vaccination cost was 239 US dollars per person, and was associated with 0.0409 quality-adjusted days saved, for a marginal cost-effectiveness ratio of 113 US dollars per quality-adjusted day gained or 41,000 US dollars per quality-adjusted life-year saved compared with antiviral therapy. No intervention was the most expensive and least effective option. In sensitivity analyses, lower vaccination costs, higher annual probabilities of influenza, and higher numbers of workdays lost to influenza made vaccination more cost-effective than treatment. If vaccination cost was less than 16 US dollars or time lost from work exceeded 2.4 days per episode of influenza, then vaccination was cost saving compared with all other strategies.

CONCLUSION

Influenza vaccination for healthy working adults is reasonable economically, and under certain circumstances is cost saving. Antiviral therapy is consistently cost saving.

Authors+Show Affiliations

Division of General Medicine and Geriatrics, Department of Medicine, Baystate Medical Center, 759 Chestnut Street, Springfield, Massachusetts 01199, USA. michael.rothberg@bhs.orgNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15639212

Citation

Rothberg, Michael B., and David N. Rose. "Vaccination Versus Treatment of Influenza in Working Adults: a Cost-effectiveness Analysis." The American Journal of Medicine, vol. 118, no. 1, 2005, pp. 68-77.
Rothberg MB, Rose DN. Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis. Am J Med. 2005;118(1):68-77.
Rothberg, M. B., & Rose, D. N. (2005). Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis. The American Journal of Medicine, 118(1), pp. 68-77.
Rothberg MB, Rose DN. Vaccination Versus Treatment of Influenza in Working Adults: a Cost-effectiveness Analysis. Am J Med. 2005;118(1):68-77. PubMed PMID: 15639212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaccination versus treatment of influenza in working adults: a cost-effectiveness analysis. AU - Rothberg,Michael B, AU - Rose,David N, PY - 2003/03/10/received PY - 2004/03/15/revised PY - 2004/03/15/accepted PY - 2005/1/11/pubmed PY - 2005/2/4/medline PY - 2005/1/11/entrez SP - 68 EP - 77 JF - The American journal of medicine JO - Am. J. Med. VL - 118 IS - 1 N2 - PURPOSE: To determine the cost-effectiveness of influenza vaccination, antiviral therapy, or no intervention for healthy working adults, accounting for annual variation in vaccine efficacy. METHODS: We conducted a cost-effectiveness analysis based on published clinical trials of influenza vaccine and antiviral drugs, incorporating 10 years of surveillance data from the World Health Organization. We modeled influenza vaccination, treatment of influenza-like illness with antiviral drugs, or both, as compared with no intervention, targeting healthy working adults under age 50 years in the general community or workplace. Outcomes included costs, illness days, and quality-adjusted days gained. RESULTS: In the base case analysis, the majority of costs incurred for all strategies were related to lost productivity from influenza illness. The least expensive strategy varied from year to year. For the 10-year period, antiviral therapy without vaccination was associated with the lowest overall costs (234 US dollars per person per year). Annual vaccination cost was 239 US dollars per person, and was associated with 0.0409 quality-adjusted days saved, for a marginal cost-effectiveness ratio of 113 US dollars per quality-adjusted day gained or 41,000 US dollars per quality-adjusted life-year saved compared with antiviral therapy. No intervention was the most expensive and least effective option. In sensitivity analyses, lower vaccination costs, higher annual probabilities of influenza, and higher numbers of workdays lost to influenza made vaccination more cost-effective than treatment. If vaccination cost was less than 16 US dollars or time lost from work exceeded 2.4 days per episode of influenza, then vaccination was cost saving compared with all other strategies. CONCLUSION: Influenza vaccination for healthy working adults is reasonable economically, and under certain circumstances is cost saving. Antiviral therapy is consistently cost saving. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/15639212/Vaccination_versus_treatment_of_influenza_in_working_adults:_a_cost_effectiveness_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(04)00629-1 DB - PRIME DP - Unbound Medicine ER -