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Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.
PLoS One. 2011; 6(7):e22308.Plos

Abstract

BACKGROUND

Pandemic influenza A(H1N1) (pH1N1) was first identified in North America in April 2009. Vaccination against pH1N1 commenced in the U.S. in October 2009 and continued through January 2010. The objective of this study was to evaluate the cost-effectiveness of pH1N1 vaccination.

METHODOLOGY

A computer simulation model was developed to predict costs and health outcomes for a pH1N1 vaccination program using inactivated vaccine compared to no vaccination. Probabilities, costs and quality-of-life weights were derived from emerging primary data on pH1N1 infections in the US, published and unpublished data for seasonal and pH1N1 illnesses, supplemented by expert opinion. The modeled target population included hypothetical cohorts of persons aged 6 months and older stratified by age and risk. The analysis used a one-year time horizon for most endpoints but also includes longer-term costs and consequences of long-term sequelae deaths. A societal perspective was used. Indirect effects (i.e., herd effects) were not included in the primary analysis. The main endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted life year (QALY) gained. Sensitivity analyses were conducted.

RESULTS

For vaccination initiated prior to the outbreak, pH1N1 vaccination was cost-saving for persons 6 months to 64 years under many assumptions. For those without high risk conditions, incremental cost-effectiveness ratios ranged from $8,000-$52,000/QALY depending on age and risk status. Results were sensitive to the number of vaccine doses needed, costs of vaccination, illness rates, and timing of vaccine delivery.

CONCLUSIONS

Vaccination for pH1N1 for children and working-age adults is cost-effective compared to other preventive health interventions under a wide range of scenarios. The economic evidence was consistent with target recommendations that were in place for pH1N1 vaccination. We also found that the delays in vaccine availability had a substantial impact on the cost-effectiveness of vaccination.

Authors+Show Affiliations

Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan Health System, Ann Arbor, Michigan, United States of America. lisapros@med.umich.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

21829456

Citation

Prosser, Lisa A., et al. "Cost-effectiveness of 2009 Pandemic Influenza A(H1N1) Vaccination in the United States." PloS One, vol. 6, no. 7, 2011, pp. e22308.
Prosser LA, Lavelle TA, Fiore AE, et al. Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States. PLoS One. 2011;6(7):e22308.
Prosser, L. A., Lavelle, T. A., Fiore, A. E., Bridges, C. B., Reed, C., Jain, S., Dunham, K. M., & Meltzer, M. I. (2011). Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States. PloS One, 6(7), e22308. https://doi.org/10.1371/journal.pone.0022308
Prosser LA, et al. Cost-effectiveness of 2009 Pandemic Influenza A(H1N1) Vaccination in the United States. PLoS One. 2011;6(7):e22308. PubMed PMID: 21829456.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States. AU - Prosser,Lisa A, AU - Lavelle,Tara A, AU - Fiore,Anthony E, AU - Bridges,Carolyn B, AU - Reed,Carrie, AU - Jain,Seema, AU - Dunham,Kelly M, AU - Meltzer,Martin I, Y1 - 2011/07/29/ PY - 2010/07/14/received PY - 2011/06/23/accepted PY - 2011/8/11/entrez PY - 2011/8/11/pubmed PY - 2011/12/13/medline SP - e22308 EP - e22308 JF - PloS one JO - PLoS One VL - 6 IS - 7 N2 - BACKGROUND: Pandemic influenza A(H1N1) (pH1N1) was first identified in North America in April 2009. Vaccination against pH1N1 commenced in the U.S. in October 2009 and continued through January 2010. The objective of this study was to evaluate the cost-effectiveness of pH1N1 vaccination. METHODOLOGY: A computer simulation model was developed to predict costs and health outcomes for a pH1N1 vaccination program using inactivated vaccine compared to no vaccination. Probabilities, costs and quality-of-life weights were derived from emerging primary data on pH1N1 infections in the US, published and unpublished data for seasonal and pH1N1 illnesses, supplemented by expert opinion. The modeled target population included hypothetical cohorts of persons aged 6 months and older stratified by age and risk. The analysis used a one-year time horizon for most endpoints but also includes longer-term costs and consequences of long-term sequelae deaths. A societal perspective was used. Indirect effects (i.e., herd effects) were not included in the primary analysis. The main endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted life year (QALY) gained. Sensitivity analyses were conducted. RESULTS: For vaccination initiated prior to the outbreak, pH1N1 vaccination was cost-saving for persons 6 months to 64 years under many assumptions. For those without high risk conditions, incremental cost-effectiveness ratios ranged from $8,000-$52,000/QALY depending on age and risk status. Results were sensitive to the number of vaccine doses needed, costs of vaccination, illness rates, and timing of vaccine delivery. CONCLUSIONS: Vaccination for pH1N1 for children and working-age adults is cost-effective compared to other preventive health interventions under a wide range of scenarios. The economic evidence was consistent with target recommendations that were in place for pH1N1 vaccination. We also found that the delays in vaccine availability had a substantial impact on the cost-effectiveness of vaccination. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/21829456/Cost_effectiveness_of_2009_pandemic_influenza_A_H1N1__vaccination_in_the_United_States_ L2 - https://dx.plos.org/10.1371/journal.pone.0022308 DB - PRIME DP - Unbound Medicine ER -