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ECONOMIC EVALUATION OF AN INFLUENZA IMMUNIZATION STRATEGY OF HEALTHY CHILDREN

Published online by Cambridge University Press:  21 November 2014

Meghann Gregg ,
Gordon Blackhouse ,
Mark Loeb  and
Ron Goeree
Meghann Gregg
Affiliation:
Health Economics Department, GlaxoSmithKline Vaccines, Wavre, Belgiummeglgregg@gmail.com
Gordon Blackhouse
Affiliation:
McMaster University, Clinical Epidemiology and Biostatistics; PATH Research Institute
Mark Loeb
Affiliation:
McMaster University, Department of Pathology and Molecular Medicine
Ron Goeree
Affiliation:
McMaster University, Clinical Epidemiology and Biostatistics
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Abstract

Objectives: Vaccinating healthy children is proposed as a strategy to produce a herd effect and protect vulnerable groups. The Hutterite Influenza Prevention Study investigated this strategy, comparing communities with or without childhood influenza immunization programs. There are costs associated with vaccination therefore there may be a trade-off between these costs and the benefits of avoiding influenza cases. This evaluation estimates the cost-effectiveness of immunizing only healthy children in preventing cases of influenza within entire communities.

Methods: Effect data and resource utilization were collected during the trial. Cost data were collected from payer, literature and Internet sources. A two-stage bootstrap (TSB) with shrinkage correction was used to estimate average costs and effects. The incremental cost effectiveness ratio (ICER) and sample uncertainty around this estimate were calculated from the TSB results.

Results: Mean costs per patient for the treatment and control arms were $69.07 and $32.66 (difference $36.41). Mean number of influenza cases for the treatment and control arms were 0.04 and 0.27 (difference 0.23). ICER was $164.12 ($28.38, $2767.75) per case of influenza averted.

Conclusions: Immunizing healthy children for influenza is more costly, yet more effective than no immunization in preventing cases in the sample. At a cost of $164.12 to prevent a case of influenza, immunizing healthy children to protect all community members may be considered costeffective. Estimated results are conservative as the influenza season was mild and the sample population was healthy. In a more severe season with a less healthy population the ICER is expected to decrease.

Keywords

Human InfluenzaInfluenza VaccinesMedical EconomicsChildAdolescent
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 30 , Issue 4 , October 2014 , pp. 394 - 399
Copyright
Copyright © Cambridge University Press 2014 

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References

REFERENCES

1. Dolin, R, Hirsch, MS, Thorner, AR. Epidemiology of influenza. Up to date. www.uptodate.com/contents/epidemiology-of-influenza (accessed September 8, 2011).Google Scholar
2. Ferroni, E, Jefferson, T. Influenza. Clinical evidence (Online), 2011. http://clinicalevidence.bmj.com.libaccess.lib.mcmaster.ca/x/pdf/clinical-evidence/en-gb/systematic-review/0911.pdf (accessed October 21, 2011).Google Scholar
3. Milenkovic, M, Russo, CA, Exilhauser, A. Hospital stays for influenza, 2004. Statistical Brief #16. Washington, DC: Agency for Healthcare Research and Quality; 2006.Google Scholar
4. Jordan, R, Connock, M, Albon, E, et al. Universal vaccination of children against influenza: Are there indirect benefits to the community? A systematic review of the evidence. Vaccine. 2006;24:1047–1062.Google Scholar
5. John, TJ, Samuel, R. Herd immunity and herd effect: New insights and definitions. Eur J Epidemiol. 2000;16:601–606.CrossRefGoogle ScholarPubMed
6. Wallinga, J, Teunis, P, Kretzchmar, M. Using data on social contracts to estimate age-specific transmission parameters for repiratory-spread infectious agents. Am J Epidemiol. 2006;164:936–944.CrossRefGoogle Scholar
7. Viboud, C, Boelle, P, Cauchemez, S, et al. Risk factors of influenza transmission in households. Br J Gen Pract. 2004;54:684–689.Google Scholar
8. Piedra, PA, Gaglani, MJ, Kozinetz, CA, et al. Herd immunity in adults against influenza-related illnesses with use of the trivalent-live attenuated influenza vaccine (CAIV-T) in children. Vaccine. 2005;23:1540–1548.CrossRefGoogle ScholarPubMed
9. Talbot, HK, Poehling, KA, Williams, JV, et al. Influenza in older adults: Impact of vaccination of school children. Vaccine. 2009;27:1923–1927.Google Scholar
10. Cohen, SA, Chui, KK, Naumova, EN. Influenza vaccination in young children reduces influenza-associated hospitalizations in older adults, 2002–2006. J Am Geriatr Soc. 2011;59:327–332.CrossRefGoogle ScholarPubMed
11. Reichert, TA, Sugaya, N, Fedson, DS, et al. The Japanese experience with vaccinating schoolchildren against influenza. N Engl J Med. 2001;344:889–896.Google Scholar
12. King, JC, Stoddard, JJ, Gaglani, MJ, et al. Effectiveness of school-based influenza vaccination. N Engl J Med. 2006;335:2523–2532.CrossRefGoogle Scholar
13. Hurwitz, ES, Haber, M, Chang, A, et al. Effectiveness of influenza vaccination of day care children in reducing influenza-related morbidity among household contacts. JAMA, 2000;284:1677–1682.Google Scholar
14. Loeb, M, Russell, ML, Moss, L, et al. Effect of influenza vaccination of children on infection rates in Hutterite communities, a randomized trial. JAMA. 2010;303:943–950.CrossRefGoogle ScholarPubMed
15. Ontario Ministry of Health and Long Term Care. Ontario Health Insurance (OHIP) schedule of benefits and fees. 2011. http://www.health.gov.on.ca/english/providers/program/ohip/sob/sob_mn.html (accessed December 15, 2011).Google Scholar
16. Ontario Case Costing Initiative. OCCI costing analysis tool. 2011. http://www.occp.com/mainPage.htm (accessed December 15, 2011).Google Scholar
17. Sander, B, Bauch, CT, Fisman, D, et al. Is a mass immunization program for pandemic (H1N1) 2009 good value for money? Evidence from the Canadian experience. Vaccine. 2010;28:6210–6220.CrossRefGoogle ScholarPubMed
18. Levofloxacin Drug Information. Up To date. 2011. http://www.uptodate.com/contents/levofloxacin-drug-information (accessed December 15, 2011).Google Scholar
19. Statistics Canada. Average hourly wages of employees by selected characteristics and profession, unadjusted data, by province (monthly) (Canada), 2011. http://www40.statcan.ca/l01/cst01/labr69a-eng.htm (accessed November 18, 2011).Google Scholar
20. Bank of Canada. Inflation calculator, 2011. http://www.bankofcanada.ca/rates/related/inflation-calculator/ (accessed December 15, 2011).Google Scholar
21. Gomes, M, Grieve, R, Nixon, R, Edmunds, WJ. Statistical methods for cost-effectiveness analysis that use data from cluster randomized trials: A systematic review and checklist for critical appraisal. Med Decis Making. 2012;32:209–220.Google Scholar
22. Gomes, M, Ng, ESW, Grieve, R, et al. Developing appropriate methods for cost-effectiveness analysis of cluster randomized trials. Med Decis Making. 2012;32:350–361.CrossRefGoogle ScholarPubMed
23. Cascade Healthcare Solutions. 25 gauge, 1”, case of 1000 brand Medline, 2011. http://www.cascadehealthcaresolutions.com/product-p/swd825112z.htm?click=71 (accessed November 18, 2011).Google Scholar
24. Ontario Nurses’ Association. FAQ, how do salaries compare based on expertise and education versus seniority? 2011. http://www.ona.org/faqs.html#f18 (accessed November 18, 2011).Google Scholar
25. St. Mark's Anglican Church, Niagara on the Lake, Ontario. Hall rental. 2011. http://www.stmarks1792.com/page/Frequently_Asked_Questions (accessed November 18, 2011).Google Scholar
26. Royal Canadian Legion Branch 459, Stouffville, Ontario. Hall rental. 2011. http://www.stouffvillelegion.ca/wp-content/forms/Hall%20Rental%20Contract%20Molstar.pdf (accessed November 18. 2011).Google Scholar
27. Royal Canadian Legion Branch 197, Acton, Ontario. Hall rental. 2011. http://www.rclbr197.org/About_Us/Hall_Rental.asp (accessed November 18, 2011).Google Scholar
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