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Bartsch SM, O'Shea KJ, Weatherwax C, Strych U, Velmurugan K, John DC, Bottazzi ME, Hussein M, Martinez MF, Chin KL, Ciciriello A, Heneghan J, Dibbs A, Scannell SA, Hotez PJ, Lee BY. What Is the Economic Benefit of Annual COVID-19 Vaccination From the Adult Individual Perspective? J Infect Dis 2024; 230:382-393. [PMID: 38581432 PMCID: PMC11326810 DOI: 10.1093/infdis/jiae179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/20/2024] [Accepted: 04/04/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND With coronavirus disease 2019 (COVID-19) vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward. METHODS We developed a Markov model representing the potential clinical/economic outcomes from an individual perspective in the United States of getting versus not getting an annual COVID-19 vaccine. RESULTS For an 18-49 year old, getting vaccinated at its current price ($60) can save the individual on average $30-$603 if the individual is uninsured and $4-$437 if the individual has private insurance, as long as the starting vaccine efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is ≥50% and the weekly risk of getting infected is ≥0.2%, corresponding to an individual interacting with 9 other people in a day under Winter 2023-2024 Omicron SARS-CoV-2 variant conditions with an average infection prevalence of 10%. For a 50-64 year old, these cost-savings increase to $111-$1278 and $119-$1706 for someone without and with insurance, respectively. The risk threshold increases to ≥0.4% (interacting with 19 people/day), when the individual has 13.4% preexisting protection against infection (eg, vaccinated 9 months earlier). CONCLUSIONS There is both clinical and economic incentive for the individual to continue to get vaccinated against COVID-19 each year.
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Affiliation(s)
- Sarah M Bartsch
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Kelly J O'Shea
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Colleen Weatherwax
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Ulrich Strych
- National School of Tropical Medicine, Department of Pediatrics, and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, USA
| | - Kavya Velmurugan
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Danielle C John
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Maria Elena Bottazzi
- National School of Tropical Medicine, Department of Pediatrics, and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Mustafa Hussein
- Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
| | - Marie F Martinez
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Kevin L Chin
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Allan Ciciriello
- National School of Tropical Medicine, Department of Pediatrics, and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, USA
| | - Jessie Heneghan
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Alexis Dibbs
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Sheryl A Scannell
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
| | - Peter J Hotez
- National School of Tropical Medicine, Department of Pediatrics, and Texas Children's Hospital Center for Vaccine Development, Baylor College of Medicine, Houston, Texas, USA
- Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas, USA
| | - Bruce Y Lee
- Public Health Informatics, Computational, and Operations Research, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Center for Advanced Technology and Communication in Health, Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
- Pandemic Response Institute, New York City, New York, USA
- Graduate School of Public Health and Health Policy, City University of New York, New York City, New York, USA
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Abreu C, Martins A, Branco E, Rocha R, Sarmento A, Magro F. Vaccines - beliefs and concerns: the voice of patients with inflammatory immunomediated diseases. Eur J Gastroenterol Hepatol 2023; 35:848-853. [PMID: 37395237 PMCID: PMC10476580 DOI: 10.1097/meg.0000000000002589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 03/11/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Vaccination is a key issue in patients with immunomodulated inflammatory diseases on immune-mediated therapy. Still, vaccination rates in these patients are low. This study aimed to assess the knowledge and fears of patients with immune-mediated inflammatory diseases (IMIDs) regarding vaccines, with the ultimate goal of increasing vaccination rates through the definition and implementation of more effective communication strategies with the patient. METHODS This study was conducted in a Portuguese hospital, between January 2019-December 2020, and included adult patients with an IMID. A questionnaire was developed and applied to evaluate knowledge and fears regarding vaccines. RESULTS From the 275 included patients, more than 90% answered correctly to all questions on general knowledge, with an exception for the question related to protection from severe disease, without differences between age groups or education levels, except for the question about vaccine contraindications (P = 0.017). Regarding vaccines in immunocompromised hosts, the proportion of correct answers was lower and significantly different between education levels (P = 0.00-0.042),. More than 50% of the participants showed moderate to very high concern about several aspects of vaccines, with differences between age groups (P = 0.018). CONCLUSION Our patients have general knowledge of vaccines but regarding vaccines in immunocompromised patients knowledge is lower and dependent on the education level. In addition, age influences the pattern of concerns related to vaccines. The information gathered in this study shall be considered to identify potential local interventions targeted to improve vaccination.
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Affiliation(s)
- Cândida Abreu
- Department of Infectious Diseases, Centro Hospitalar Universitário São João, Porto
- Instituto de Inovação e Investigação em Saúde (I3S)
- Instituto Nacional de Engenharia Biomédica (INEB)
- Faculty of Medicine, Department of Medicine, University of Porto
| | - António Martins
- Department of Infectious Diseases, Centro Hospitalar Universitário São João, Porto
- Instituto de Inovação e Investigação em Saúde (I3S)
- Instituto Nacional de Engenharia Biomédica (INEB)
- Faculty of Medicine, Department of Medicine, University of Porto
| | - Elsa Branco
- Department of Infectious Diseases, Centro Hospitalar Universitário São João, Porto
- Instituto de Inovação e Investigação em Saúde (I3S)
- Instituto Nacional de Engenharia Biomédica (INEB)
- Faculty of Medicine, Department of Medicine, University of Porto
| | - Rafael Rocha
- Department of Infectious Diseases, Centro Hospitalar Universitário São João, Porto
- Instituto de Inovação e Investigação em Saúde (I3S)
- Instituto Nacional de Engenharia Biomédica (INEB)
- Faculty of Medicine, Department of Medicine, University of Porto
| | - António Sarmento
- Department of Infectious Diseases, Centro Hospitalar Universitário São João, Porto
- Instituto de Inovação e Investigação em Saúde (I3S)
- Instituto Nacional de Engenharia Biomédica (INEB)
- Faculty of Medicine, Department of Medicine, University of Porto
| | - Fernando Magro
- Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto
- Department of Gastroenterology, São João Hospital Center
- Clinical Pharmacology Unit, São João Hospital University Center, Porto, Portugal
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Calabro' GE, Carini E, Tognetto A, Giacchetta I, Bonanno E, Mariani M, Ricciardi W, de Waure C. The Value(s) of Vaccination: Building the Scientific Evidence According to a Value-Based Healthcare Approach. Front Public Health 2022; 10:786662. [PMID: 35359753 PMCID: PMC8963736 DOI: 10.3389/fpubh.2022.786662] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/31/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives To provide a new value-based immunization approach collating the available scientific evidence on the topic. Methods Four value pillars (personal, allocative, technical, and societal) applied to vaccination field were investigated. A systematic literature review was performed querying three database from December 24th, 2010 to May 27th, 2020. It included studies on vaccine-preventable diseases (VPDs) that mentioned the term value in any part and which were conducted in advanced economies. An in-depth analysis was performed on studies addressing value as key element. Results Overall, 107 studies were considered. Approximately half of the studies addressed value as a key element but in most of cases (83.3%) only a single pillar was assessed. Furthermore, the majority of papers addressed the technical value by looking only at classical methods for economic assessment of vaccinations whereas very few dealt with societal and allocative pillars. Conclusions Estimating the vaccinations value is very complex, even though their usefulness is certain. The assessment of the whole value of vaccines and vaccinations is still limited to some domains and should encompass the wider impact on economic growth and societies.
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Affiliation(s)
- Giovanna Elisa Calabro'
- Section of Hygiene, University Department of Life Sciences and Public Health; Catholic University of the Sacred Heart, Rome, Italy
- VIHTALI (Value In Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elettra Carini
- Section of Hygiene, University Department of Life Sciences and Public Health; Catholic University of the Sacred Heart, Rome, Italy
| | | | - Irene Giacchetta
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Ester Bonanno
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Marco Mariani
- Section of Hygiene, University Department of Life Sciences and Public Health; Catholic University of the Sacred Heart, Rome, Italy
| | - Walter Ricciardi
- Section of Hygiene, University Department of Life Sciences and Public Health; Catholic University of the Sacred Heart, Rome, Italy
| | - Chiara de Waure
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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Marmara V, Marmara D, McMenemy P, Kleczkowski A. Cross-sectional telephone surveys as a tool to study epidemiological factors and monitor seasonal influenza activity in Malta. BMC Public Health 2021; 21:1828. [PMID: 34627201 PMCID: PMC8502089 DOI: 10.1186/s12889-021-11862-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 09/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Seasonal influenza has major implications for healthcare services as outbreaks often lead to high activity levels in health systems. Being able to predict when such outbreaks occur is vital. Mathematical models have extensively been used to predict epidemics of infectious diseases such as seasonal influenza and to assess effectiveness of control strategies. Availability of comprehensive and reliable datasets used to parametrize these models is limited. In this paper we combine a unique epidemiological dataset collected in Malta through General Practitioners (GPs) with a novel method using cross-sectional surveys to study seasonal influenza dynamics in Malta in 2014–2016, to include social dynamics and self-perception related to seasonal influenza. Methods Two cross-sectional public surveys (n = 406 per survey) were performed by telephone across the Maltese population in 2014–15 and 2015–16 influenza seasons. Survey results were compared with incidence data (diagnosed seasonal influenza cases) collected by GPs in the same period and with Google Trends data for Malta. Information was collected on whether participants recalled their health status in past months, occurrences of influenza symptoms, hospitalisation rates due to seasonal influenza, seeking GP advice, and other medical information. Results We demonstrate that cross-sectional surveys are a reliable alternative data source to medical records. The two surveys gave comparable results, indicating that the level of recollection among the public is high. Based on two seasons of data, the reporting rate in Malta varies between 14 and 22%. The comparison with Google Trends suggests that the online searches peak at about the same time as the maximum extent of the epidemic, but the public interest declines and returns to background level. We also found that the public intensively searched the Internet for influenza-related terms even when number of cases was low. Conclusions Our research shows that a telephone survey is a viable way to gain deeper insight into a population’s self-perception of influenza and its symptoms and to provide another benchmark for medical statistics provided by GPs and Google Trends. The information collected can be used to improve epidemiological modelling of seasonal influenza and other infectious diseases, thus effectively contributing to public health. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11862-x.
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Affiliation(s)
- V Marmara
- Faculty of Economics, Management & Accountancy, University of Malta, Msida, MSD, 2080, Malta
| | - D Marmara
- Faculty of Health Sciences, Mater Dei Hospital, Block A, Level 1, University of Malta, Msida, MSD, 2090, Malta.
| | - P McMenemy
- Department of Mathematics, University of Stirling, Stirling, FK94LA, Scotland, UK
| | - A Kleczkowski
- Department of Mathematics and Statistics, University of Strathclyde, Rm. 1001, 26 Richmond Street, Glasgow, G1 1XH, Scotland
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5
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Fens T, de Boer PT, van Puijenbroek EP, Postma MJ. Inclusion of Safety-Related Issues in Economic Evaluations for Seasonal Influenza Vaccines: A Systematic Review. Vaccines (Basel) 2021; 9:vaccines9020111. [PMID: 33540633 PMCID: PMC7913116 DOI: 10.3390/vaccines9020111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/18/2021] [Accepted: 01/26/2021] [Indexed: 11/18/2022] Open
Abstract
(1) Background: Vaccines for seasonal influenza are a good preventive and cost-effective strategy. However, it is unknown if and how these economic evaluations include the adverse events following immunization (AEFI), and what the impact of such inclusion is on the health economic outcomes. (2) Methods: We searched the literature, up to January 2020, to identify economic evaluations of seasonal influenza vaccines that considered AEFIs. The review protocol was published in PROSPERO (CDR42017058523). (3) Results: A total of 52 economic evaluations considered AEFI-related parameters in their analyses, reflecting 16% of the economic evaluations on seasonal influenza vaccines in the initial study selection. Most studies used the societal perspective (64%) and evaluated vaccination of children (37%). Where considered, studies included direct medical costs of AEFIs (90%), indirect costs (27%), and disutilities/quality-adjusted life years loss due to AEFIs (37%). The majority of these studies accounted for the effects of the costs of AEFI on cost-effectiveness for Guillain–Barré syndrome. In those papers allowing cost share estimation, direct medical cost of AFEIs was less than 2% of total direct costs. (4) Conclusions: Although the overall impact of AEFIs on the cost-effectiveness outcomes was found to be low, we urge their inclusion in economic evaluations of seasonal influenza vaccines to reflect comprehensive reports for the decision makers and end-users of the vaccination strategies.
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Affiliation(s)
- Tanja Fens
- Department of PharmacoTherapy, Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands; (P.T.d.B.); (E.P.v.P.); (M.J.P.)
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Correspondence:
| | - Pieter T. de Boer
- Department of PharmacoTherapy, Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands; (P.T.d.B.); (E.P.v.P.); (M.J.P.)
| | - Eugène P. van Puijenbroek
- Department of PharmacoTherapy, Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands; (P.T.d.B.); (E.P.v.P.); (M.J.P.)
- Netherlands Pharmacovigilance Centre Lareb, 5237 MH ’s-Hertogenbosch, The Netherlands
| | - Maarten J. Postma
- Department of PharmacoTherapy, Epidemiology & -Economics (PTE2), Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands; (P.T.d.B.); (E.P.v.P.); (M.J.P.)
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Department of Economics, Econometrics & Finance, Faculty of Economics & Business, University of Groningen, 9747 AE Groningen, The Netherlands
- Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung 45363, Indonesia
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Kellerborg K, Brouwer W, van Baal P. Costs and benefits of interventions aimed at major infectious disease threats: lessons from the literature. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:1329-1350. [PMID: 32789780 PMCID: PMC7425274 DOI: 10.1007/s10198-020-01218-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 07/03/2020] [Indexed: 06/11/2023]
Abstract
Pandemics and major outbreaks have the potential to cause large health losses and major economic costs. To prioritize between preventive and responsive interventions, it is important to understand the costs and health losses interventions may prevent. We review the literature, investigating the type of studies performed, the costs and benefits included, and the methods employed against perceived major outbreak threats. We searched PubMed and SCOPUS for studies concerning the outbreaks of SARS in 2003, H5N1 in 2003, H1N1 in 2009, Cholera in Haiti in 2010, MERS-CoV in 2013, H7N9 in 2013, and Ebola in West-Africa in 2014. We screened titles and abstracts of papers, and subsequently examined remaining full-text papers. Data were extracted according to a pre-constructed protocol. We included 34 studies of which the majority evaluated interventions related to the H1N1 outbreak in a high-income setting. Most interventions concerned pharmaceuticals. Included costs and benefits, as well as the methods applied, varied substantially between studies. Most studies used a short time horizon and did not include future costs and benefits. We found substantial variation in the included elements and methods used. Policymakers need to be aware of this and the bias toward high-income countries and pharmaceutical interventions, which hampers generalizability. More standardization of included elements, methodology, and reporting would improve economic evaluations and their usefulness for policy.
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Affiliation(s)
- Klas Kellerborg
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Werner Brouwer
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Pieter van Baal
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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7
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Leidner AJ, Murthy N, Chesson HW, Biggerstaff M, Stoecker C, Harris AM, Acosta A, Dooling K, Bridges CB. Cost-effectiveness of adult vaccinations: A systematic review. Vaccine 2018; 37:226-234. [PMID: 30527660 DOI: 10.1016/j.vaccine.2018.11.056] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/29/2018] [Accepted: 11/16/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Coverage levels for many recommended adult vaccinations are low. The cost-effectiveness research literature on adult vaccinations has not been synthesized in recent years, which may contribute to low awareness of the value of adult vaccinations and to their under-utilization. We assessed research literature since 1980 to summarize economic evidence for adult vaccinations included on the adult immunization schedule. METHODS We searched PubMed, EMBASE, EconLit, and Cochrane Library from 1980 to 2016 and identified economic evaluation or cost-effectiveness analysis for vaccinations targeting persons aged ≥18 years in the U.S. or Canada. After excluding records based on title and abstract reviews, the remaining publications had a full-text review from two independent reviewers, who extracted economic values that compared vaccination to "no vaccination" scenarios. RESULTS The systematic searches yielded 1688 publications. After removing duplicates, off-topic publications, and publications without a "no vaccination" comparison, 78 publications were included in the final analysis (influenza = 25, pneumococcal = 18, human papillomavirus = 9, herpes zoster = 7, tetanus-diphtheria-pertussis = 9, hepatitis B = 9, and multiple vaccines = 1). Among outcomes assessing age-based vaccinations, the percent indicating cost-savings was 56% for influenza, 31% for pneumococcal, and 23% for tetanus-diphtheria-pertussis vaccinations. Among age-based vaccination outcomes reporting $/QALY, the percent of outcomes indicating a cost per QALY of ≤$100,000 was 100% for influenza, 100% for pneumococcal, 69% for human papillomavirus, 71% for herpes zoster, and 50% for tetanus-diphtheria-pertussis vaccinations. CONCLUSIONS The majority of published studies report favorable cost-effectiveness profiles for adult vaccinations, which supports efforts to improve the implementation of adult vaccination recommendations.
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Affiliation(s)
| | - Neil Murthy
- National Center for Immunization and Respiratory Diseases, CDC, USA; Epidemic Intelligence Service, CDC, USA
| | - Harrell W Chesson
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, USA
| | | | - Charles Stoecker
- School of Public Health and Tropical Medicine, Tulane University, USA
| | - Aaron M Harris
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, USA
| | - Anna Acosta
- National Center for Immunization and Respiratory Diseases, CDC, USA
| | - Kathleen Dooling
- National Center for Immunization and Respiratory Diseases, CDC, USA
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8
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Basurto‐Dávila R, Meltzer MI, Mills DA, Beeler Asay GR, Cho B, Graitcer SB, Dube NL, Thompson MG, Patel SA, Peasah SK, Ferdinands JM, Gargiullo P, Messonnier M, Shay DK. School-Based Influenza Vaccination: Health and Economic Impact of Maine's 2009 Influenza Vaccination Program. Health Serv Res 2017; 52 Suppl 2:2307-2330. [PMID: 29130266 PMCID: PMC5682124 DOI: 10.1111/1475-6773.12786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To estimate the societal economic and health impacts of Maine's school-based influenza vaccination (SIV) program during the 2009 A(H1N1) influenza pandemic. DATA SOURCES Primary and secondary data covering the 2008-09 and 2009-10 influenza seasons. STUDY DESIGN We estimated weekly monovalent influenza vaccine uptake in Maine and 15 other states, using difference-in-difference-in-differences analysis to assess the program's impact on immunization among six age groups. We also developed a health and economic Markov microsimulation model and conducted Monte Carlo sensitivity analysis. DATA COLLECTION We used national survey data to estimate the impact of the SIV program on vaccine coverage. We used primary data and published studies to develop the microsimulation model. PRINCIPAL FINDINGS The program was associated with higher immunization among children and lower immunization among adults aged 18-49 years and 65 and older. The program prevented 4,600 influenza infections and generated $4.9 million in net economic benefits. Cost savings from lower adult vaccination accounted for 54 percent of the economic gain. Economic benefits were positive in 98 percent of Monte Carlo simulations. CONCLUSIONS SIV may be a cost-beneficial approach to increase immunization during pandemics, but programs should be designed to prevent lower immunization among nontargeted groups.
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Affiliation(s)
| | | | | | | | - Bo‐Hyun Cho
- Centers for Disease Control and PreventionAtlantaGA
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9
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Inguva S, Sautter JM, Chun GJ, Patterson BJ, McGhan WF. Population characteristics associated with pharmacy-based influenza vaccination in United States survey data. J Am Pharm Assoc (2003) 2017; 57:654-660. [PMID: 28830660 DOI: 10.1016/j.japh.2017.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/18/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To examine the population characteristics associated with the health behavior of receiving an influenza vaccine from a pharmacy-based setting. DESIGN Secondary analysis of data from states that participated in an optional influenza module in the 2014 Behavioral Risk Factor Surveillance System, a state-based observational survey of U.S. adults. SETTING AND PARTICIPANTS Analytic sample of 28,954 respondents from 8 states and Puerto Rico who reported receiving an influenza vaccination in the past year. MAIN OUTCOME MEASURES The main outcome was a self-reported categoric variable indicating the setting of the most recent seasonal influenza vaccination: doctor's office, pharmacy-based store, or other setting. RESULTS Multinomial logistic regression results showed that environmental, predisposing, enabling, and need factors in the Andersen model were salient features associated with odds of using pharmacy-based influenza vaccination settings instead of a doctor's office. Residents of states that allowed pharmacists as immunizers before 1999 reported greater use of pharmacy-based store settings (odds ratio [OR] 1.31). Compared with young adults, individuals 65 years of age and older were more likely to choose a pharmacy-based store than a doctor's office (OR 1.41) and less likely to use other community settings (OR 0.45). Compared with non-Hispanic whites, black respondents were less likely to use pharmacy-based store vaccination (OR 0.51), and multiracial and Hispanic respondents were more likely to use other settings (ORs 1.47 and 1.60, respectively). Enabling and need factors were also associated with setting. CONCLUSION Based on this dataset of selected states from 2014, almost one-fourth of U.S. adults who reported receiving an annual influenza vaccination did so from a pharmacy-based store; 35% reported using other community-based settings that may enlist pharmacists as immunizers. There were striking disparities in use of nontraditional vaccination settings by age and race or ethnicity. Pharmacists and pharmacies should address missed opportunities for vaccination by targeting outreach efforts based on environmental and predisposing characteristics.
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Abstract
Mathematical and computational modeling can transform decision making for neglected tropical diseases (NTDs) if the right model is used for the right question. Modeling can help better understand and address the complex systems involved in making decisions for NTD prevention and control. However, all models, modelers, and modeling are not the same. Thus, decision makers need to better understand if a particular model actually fits their needs. Here are a series of questions that a decision maker can ask when determining whether a model is right for him or her.
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Affiliation(s)
- Bruce Y. Lee
- Public Health Computational and Operations Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland, United States of America
- * E-mail:
| | - Sarah M. Bartsch
- Public Health Computational and Operations Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Global Obesity Prevention Center, Johns Hopkins University, Baltimore, Maryland, United States of America
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11
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Kamal MA, Smith PF, Chaiyakunapruk N, Wu DBC, Pratoomsoot C, Lee KKC, Chong HY, Nelson RE, Nieforth K, Dall G, Toovey S, Kong DCM, Kamauu A, Kirkpatrick CM, Rayner CR. Interdisciplinary pharmacometrics linking oseltamivir pharmacology, influenza epidemiology and health economics to inform antiviral use in pandemics. Br J Clin Pharmacol 2017; 83:1580-1594. [PMID: 28176362 DOI: 10.1111/bcp.13229] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 12/06/2016] [Accepted: 12/07/2016] [Indexed: 12/17/2022] Open
Abstract
AIMS A modular interdisciplinary platform was developed to investigate the economic impact of oseltamivir treatment by dosage regimen under simulated influenza pandemic scenarios. METHODS The pharmacology module consisted of a pharmacokinetic distribution of oseltamivir carboxylate daily area under the concentration-time curve at steady state (simulated for 75 mg and 150 mg twice daily regimens for 5 days) and a pharmacodynamic distribution of viral shedding duration obtained from phase II influenza inoculation data. The epidemiological module comprised a susceptible, exposed, infected, recovered (SEIR) model to which drug effect on the basic reproductive number (R0 ), a measure of transmissibility, was linked by reduction of viral shedding duration. The number of infected patients per population of 100 000 susceptible individuals was simulated for a series of pandemic scenarios, varying oseltamivir dose, R0 (1.9 vs. 2.7), and drug uptake (25%, 50%, and 80%). The number of infected patients for each scenario was entered into the health economics module, a decision analytic model populated with branch probabilities, disease utility, costs of hospitalized patients developing complications, and case-fatality rates. Change in quality-adjusted life years was determined relative to base case. RESULTS Oseltamivir 75 mg relative to no treatment reduced the median number of infected patients, increased change in quality-adjusted life years by deaths averted, and was cost-saving under all scenarios; 150 mg relative to 75 mg was not cost effective in low transmissibility scenarios but was cost saving in high transmissibility scenarios. CONCLUSION This methodological study demonstrates proof of concept that the disciplines of pharmacology, disease epidemiology and health economics can be linked in a single quantitative framework.
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Affiliation(s)
- Mohamed A Kamal
- Regeneron Pharmaceuticals, Tarrytown, New York, USA.,Roche Innovation Center, New York, New York, USA
| | - Patrick F Smith
- d3 Medicine LLC - a Certara Company, Parsippany, New Jersey, USA
| | | | - David B C Wu
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
| | | | - Kenneth K C Lee
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
| | - Huey Yi Chong
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
| | | | - Keith Nieforth
- d3 Medicine LLC - a Certara Company, Parsippany, New Jersey, USA
| | - Georgina Dall
- d3 Medicine LLC - a Certara Company, Parsippany, New Jersey, USA
| | | | - David C M Kong
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
| | | | | | - Craig R Rayner
- School of Pharmacy, Monash University Malaysia, Selangor, Malaysia.,Faculty of Public Health, Naresuan University, Thailand
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de Boer PT, Frederix GWJ, Feenstra TL, Vemer P. Unremarked or Unperformed? Systematic Review on Reporting of Validation Efforts of Health Economic Decision Models in Seasonal Influenza and Early Breast Cancer. PHARMACOECONOMICS 2016; 34:833-845. [PMID: 27129572 PMCID: PMC4980411 DOI: 10.1007/s40273-016-0410-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Transparent reporting of validation efforts of health economic models give stakeholders better insight into the credibility of model outcomes. In this study we reviewed recently published studies on seasonal influenza and early breast cancer in order to gain insight into the reporting of model validation efforts in the overall health economic literature. METHODS A literature search was performed in Pubmed and Embase to retrieve health economic modelling studies published between 2008 and 2014. Reporting on model validation was evaluated by checking for the word validation, and by using AdViSHE (Assessment of the Validation Status of Health Economic decision models), a tool containing a structured list of relevant items for validation. Additionally, we contacted corresponding authors to ask whether more validation efforts were performed other than those reported in the manuscripts. RESULTS A total of 53 studies on seasonal influenza and 41 studies on early breast cancer were included in our review. The word validation was used in 16 studies (30 %) on seasonal influenza and 23 studies (56 %) on early breast cancer; however, in a minority of studies, this referred to a model validation technique. Fifty-seven percent of seasonal influenza studies and 71 % of early breast cancer studies reported one or more validation techniques. Cross-validation of study outcomes was found most often. A limited number of studies reported on model validation efforts, although good examples were identified. Author comments indicated that more validation techniques were performed than those reported in the manuscripts. CONCLUSIONS Although validation is deemed important by many researchers, this is not reflected in the reporting habits of health economic modelling studies. Systematic reporting of validation efforts would be desirable to further enhance decision makers' confidence in health economic models and their outcomes.
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Affiliation(s)
- Pieter T de Boer
- Department of Pharmacy, PharmacoTherapy, -Epidemiology and -Economics (PTEE), University of Groningen, Groningen, The Netherlands
| | - Geert W J Frederix
- Pharmacoepidemiology and Clinical Pharmacology, University of Utrecht, Utrecht, The Netherlands
| | - Talitha L Feenstra
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
- Centre for Nutrition, Prevention and Health Services Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Pepijn Vemer
- Department of Pharmacy, PharmacoTherapy, -Epidemiology and -Economics (PTEE), University of Groningen, Groningen, The Netherlands.
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
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Tai BWB, Bae YH, Le QA. A Systematic Review of Health Economic Evaluation Studies Using the Patient's Perspective. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:903-908. [PMID: 27712720 DOI: 10.1016/j.jval.2016.05.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 05/01/2016] [Accepted: 05/18/2016] [Indexed: 05/06/2023]
Abstract
BACKGROUND Patient-centered care has become increasingly important and relevant for informed health care decision making. OBJECTIVE Our study aimed to perform a systematic review of health economic evaluation studies from the patient's perspective. METHODS PubMed, EMBASE, and Cochrane Central databases were searched through May 2014 for cost-effectiveness, cost-utility, and cost-benefit studies using the patient's perspective in their analysis. The reporting quality of the studies was evaluated on the basis of Consolidated Health Economic Evaluation Reporting Standards. RESULTS We identified 30 health economic evaluations using the patient's perspective, of which 7 were conducted in the United States, 9 in Europe, and 14 in Asian or other countries. Seventeen of 23 health conditions evaluated were chronic in nature. Among 12 studies that justified the use of the patient's perspective, patient's financial burden associated with medical treatment was the most commonly cited rationale. A total of 29, 17, and 15 studies examined direct medical, direct nonmedical, and indirect costs, respectively. Seventeen studies also included societal, governmental or payer's, and/or provider's perspective(s) in their analyses. Based on Consolidated Health Economic Evaluation Reporting Standards, more than 20% of the reporting items in these studies were either partially satisfied or not satisfied. CONCLUSIONS There is a paucity of health economic evaluations conducted from the patient's perspective in the literature. For those studies using the patient's perspective, the true patient costs were not fully explored and study reporting quality was not optimal. With the increasing focus on patient-centered outcomes in health policy research, more frequent use of the patient's perspective in economic studies should be advocated.
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Affiliation(s)
| | - Yuna H Bae
- Department of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, Pomona, CA, USA
| | - Quang A Le
- Department of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, Pomona, CA, USA.
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14
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Taksler GB, Rothberg MB, Cutler DM. Association of Influenza Vaccination Coverage in Younger Adults With Influenza-Related Illness in the Elderly. Clin Infect Dis 2015; 61:1495-503. [PMID: 26359478 DOI: 10.1093/cid/civ630] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/08/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Older adults have the highest influenza-related morbidity and mortality risk, but the influenza vaccine is less effective in the elderly. It is unknown whether influenza vaccination of nonelderly adults confers additional disease protection on the elderly population. METHODS We examined the association between county-wide influenza vaccination coverage among 520 229 younger adults (aged 18-64 years) in the Behavioral Risk Factors Surveillance System Survey and illnesses related to influenza in 3 317 709 elderly Medicare beneficiaries aged ≥65 years, between 2002 and 2010 (13 267 786 person-years). Results were stratified by documented receipt of a seasonal influenza vaccine in each Medicare beneficiary. RESULTS Increases in county-wide vaccine coverage among younger adults were associated with lower adjusted odds of illnesses related to influenza in the elderly. Compared with elderly residents of counties with ≤15% of younger adults vaccinated, the adjusted odds ratio for a principal diagnosis of influenza among elderly residents was 0.91 (95% confidence interval, .88-.94) for counties with 16%-20% of younger adults vaccinated, 0.87 (.84-.90) for counties with 21%-25% vaccinated, 0.80 (.77-.83) for counties with 26%-30% vaccinated, and 0.79 (.76-.83) for counties with ≥31% vaccinated (P for trend <.001). Stronger associations were observed among vaccinated elderly adults, in peak months of influenza season, in more severe influenza seasons, in influenza seasons with greater antigenic match to influenza vaccine, and for more specific definitions of influenza-related illness. CONCLUSIONS In a large, nationwide sample of Medicare beneficiaries, influenza vaccination among adults aged 18-64 years was inversely associated with illnesses related to influenza in the elderly.
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Affiliation(s)
| | | | - David M Cutler
- Department of Economics and Kennedy School of Government, Harvard University, and National Bureau of Economic Research, Cambridge, Massachusetts
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15
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Lee BY, Bartsch SM, Mvundura M, Jarrahian C, Zapf KM, Marinan K, Wateska AR, Snyder B, Swaminathan S, Jacoby E, Norman JJ, Prausnitz MR, Zehrung D. An economic model assessing the value of microneedle patch delivery of the seasonal influenza vaccine. Vaccine 2015; 33:4727-36. [PMID: 25772675 PMCID: PMC4623320 DOI: 10.1016/j.vaccine.2015.02.076] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 01/06/2015] [Accepted: 02/16/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND New vaccine technologies may improve the acceptability, delivery (potentially enabling self-administration), and product efficacy of influenza vaccines. One such technology is the microneedle patch (MNP), a skin delivery technology currently in development. Although MNPs hold promise in preclinical studies, their potential economic and epidemiologic impacts have not yet been evaluated. METHODS We utilized a susceptible-exposed-infectious-recovered (SEIR) transmission model linked to an economic influenza outcomes model to assess the economic value of introducing the MNP into the current influenza vaccine market in the United States from the third-party payer and societal perspectives. We also explored the impact of different vaccination settings, self-administration, the MNP price, vaccine efficacy, compliance, and MNP market share. Outcomes included costs, quality-adjusted life years (QALYs), cases, and incremental cost-effectiveness ratios (ICERs; cost/QALY). RESULTS With healthcare provider administration, MNP introduction would be cost-effective (ICERs ≤$23,347/QALY) at all MNP price points ($9.50-$30) and market shares (10-60%) assessed, except when compliance and efficacy were assumed to be the same as existing vaccines and the MNP occupied a 10% market share. If MNP self-administration were available (assuming the same efficacy as current technologies), MNP compliance or its efficacy would need to increase by ≥3% in order to be cost-effective (ICERs ≤$1401/QALY), assuming a 2% reduction in administration success with unsupervised self-administration. Under these conditions, MNP introduction would be cost-effective for all price points and market shares assessed. CONCLUSIONS When healthcare providers administered the MNP, its introduction would be cost-effective or dominant (i.e., less costly and more effective) in the majority of scenarios assessed. If self-administration were available, MNP introduction would be cost-effective if it increased compliance enough to overcome any decrease in self-administration success or if the MNP presentation afforded an increase in efficacy over current delivery methods for influenza vaccines.
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Affiliation(s)
- Bruce Y Lee
- Johns Hopkins Bloomberg School of Public Health, 855 N Wolfe Street, Suite 600, Baltimore, MD 21205, United States.
| | - Sarah M Bartsch
- Johns Hopkins Bloomberg School of Public Health, 855 N Wolfe Street, Suite 600, Baltimore, MD 21205, United States
| | - Mercy Mvundura
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, United States
| | | | - Kristina M Zapf
- Johns Hopkins Bloomberg School of Public Health, 855 N Wolfe Street, Suite 600, Baltimore, MD 21205, United States
| | - Kathleen Marinan
- Johns Hopkins Bloomberg School of Public Health, 855 N Wolfe Street, Suite 600, Baltimore, MD 21205, United States
| | - Angela R Wateska
- Johns Hopkins Bloomberg School of Public Health, 855 N Wolfe Street, Suite 600, Baltimore, MD 21205, United States
| | - Bill Snyder
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, United States
| | | | - Erica Jacoby
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, United States
| | - James J Norman
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA 30332, United States
| | - Mark R Prausnitz
- School of Chemical and Biomolecular Engineering, Georgia Institute of Technology, 311 Ferst Drive, Atlanta, GA 30332, United States
| | - Darin Zehrung
- PATH, 2201 Westlake Avenue, Suite 200, Seattle, WA 98121, United States
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Abstract
BACKGROUND Influenza vaccination is administered throughout the influenza disease season, even as late as March. Given such timing, what is the value of vaccinating the population earlier than currently being practiced? METHODS We used real data on when individuals were vaccinated in Allegheny County, Pennsylvania, and the following 2 models to determine the value of vaccinating individuals earlier (by the end of September, October, and November): Framework for Reconstructing Epidemiological Dynamics (FRED), an agent-based model (ABM), and FluEcon, our influenza economic model that translates cases from the ABM to outcomes and costs [health care and lost productivity costs and quality-adjusted life-years (QALYs)]. We varied the reproductive number (R0) from 1.2 to 1.6. RESULTS Applying the current timing of vaccinations averted 223,761 influenza cases, $16.3 million in direct health care costs, $50.0 million in productivity losses, and 804 in QALYs, compared with no vaccination (February peak, R0 1.2). When the population does not have preexisting immunity and the influenza season peaks in February (R0 1.2-1.6), moving individuals who currently received the vaccine after September to the end of September could avert an additional 9634-17,794 influenza cases, $0.6-$1.4 million in direct costs, $2.1-$4.0 million in productivity losses, and 35-64 QALYs. Moving the vaccination of just children to September (R0 1.2-1.6) averted 11,366-1660 influenza cases, $0.6-$0.03 million in direct costs, $2.3-$0.2 million in productivity losses, and 42-8 QALYs. Moving the season peak to December increased these benefits, whereas increasing preexisting immunity reduced these benefits. CONCLUSION Even though many people are vaccinated well after September/October, they likely are still vaccinated early enough to provide substantial cost-savings.
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Abstract
As the most recent outbreak of Ebola virus disease (EVD) in West Africa continues to grow since its initial recognition as a Public Health Emergency of International Concern, an unanswered question is what is the cost of a case of Ebola? Understanding this cost will help decision makers better understand the impact of each case of EVD, benchmark this against that of other diseases, prioritize which cases may require response, and begin to estimate the cost of Ebola outbreaks. To date, the scientific literature has not characterized this cost per case. Therefore, we developed a mathematical model to estimate the cost of an EVD case from the provider and societal perspectives in the three most affected countries of Guinea, Liberia, and Sierra Leone. Our model estimates the total societal cost of an EVD case with full recovery ranges from $480 to $912, while that of an EVD case not surviving ranges from $5929 to $18 929, varying by age and country. Therefore, as of 10 December 2014, the estimated total societal costs of all reported EVD cases in these three countries range from $82 to potentially over $356 million.
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18
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Padilla ME, Jiang S, Barner JC, Rivera JO. A comparison of national immunization rates to immunization rates of Latino diabetic patients receiving clinical pharmacist interventions in a federally qualified community health centre (FQHC). JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2014. [DOI: 10.1111/jphs.12063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Margie E. Padilla
- College of Health Sciences; The University of Texas at El Paso, UTEP/UT Austin Cooperative Pharmacy Program, El Paso
- Centro San Vicente Health Clinics; El Paso
- College of Pharmacy; The University of Texas at Austin; Austin TX USA
| | - Shan Jiang
- College of Pharmacy; The University of Texas at Austin; Austin TX USA
| | - Jamie C. Barner
- College of Pharmacy; The University of Texas at Austin; Austin TX USA
| | - Jose O. Rivera
- College of Health Sciences; The University of Texas at El Paso, UTEP/UT Austin Cooperative Pharmacy Program, El Paso
- College of Pharmacy; The University of Texas at Austin; Austin TX USA
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Silva ML, Perrier L, Späth HM, Grog I, Mosnier A, Havet N, Cohen JM. Economic burden of seasonal influenza B in France during winter 2010-2011. BMC Public Health 2014; 14:56. [PMID: 24443900 PMCID: PMC3909302 DOI: 10.1186/1471-2458-14-56] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 01/17/2014] [Indexed: 11/10/2022] Open
Abstract
Background In France, 2–15% of the population is affected annually by influenza, which causes significant socioeconomic disruption. Nevertheless, despite its importance for policy makers, few published studies have evaluated the impact of influenza B. Therefore, we assessed the costs associated with influenza B during 2010–2011 in France. Methods Cases of lab-confirmed influenza B were analyzed as part of the Influenza B in General Practice Study. Cost calculations were based on micro-costing methods according to the French Health Insurance (FHI) perspective (in Euros, 2011). Costs were compared between age groups using the Kruskal–Wallis test, and when significant, by multiple comparisons based on rank. Moreover, uncertainties were assessed using one-way sensitivity and probabilistic analyses. Overall economic burden was estimated by multiplying cost per patient, flu attack rate, and the French population. Results A total of 201 patients were included in the study. We found that the mean cost associated with Influenza B was 72€ (SD: 205) per patient: 70€ (SD: 262) for younger children, 50€ (SD: 195) for older children, 126€ (SD: 180) for adults, and 42€ (SD: 18) for elderly. Thus, we observed significantly different costs between the distinct age groups (p<0.0001). Finally, the economic burden of influenza B for the FHI was estimated to be 145 million Euros (95% CI: 88–201). Conclusions Our findings highlight the important impact of influenza B and encourage further investigation on policy regarding vaccination strategies in France.
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Affiliation(s)
- Maria Laura Silva
- GATE-UMR CNRS 5824, University of Lyon, University Lumière Lyon 2, Lyon 1, Lyon, France.
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Lee B, Haidari L, Lee M. Modelling during an emergency: the 2009 H1N1 influenza pandemic. Clin Microbiol Infect 2013; 19:1014-22. [DOI: 10.1111/1469-0691.12284] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Bartsch SM, Lopman BA, Hall AJ, Parashar UD, Lee BY. The potential economic value of a human norovirus vaccine for the United States. Vaccine 2012; 30:7097-104. [PMID: 23026689 PMCID: PMC3517973 DOI: 10.1016/j.vaccine.2012.09.040] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 08/08/2012] [Accepted: 09/17/2012] [Indexed: 01/01/2023]
Abstract
Vaccines against human norovirus are currently under development. We developed a simulation model to determine their potential economic value. Vaccination prevented 100-6125 norovirus gastroenteritis cases per 10,000 vaccinees. Low vaccine cost (≤$50) garnered cost-savings and a more expensive vaccine led to costs per case averted comparable to other vaccines. In the US, vaccination could avert approximately 1.0-2.2 million cases (efficacy 50%, 12 month duration), costing an additional $400 million to $1.0 billion, but could save ≤$2.1 billion (48 month duration). Human norovirus vaccination can offer economic value while averting clinical outcomes, depending on price, efficacy, and protection duration.
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Affiliation(s)
- Sarah M. Bartsch
- Public Health Computational and Operations Research, University of Pittsburgh School of Medicine, Pittsburgh, USA
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, USA
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, USA
| | - Benjamin A. Lopman
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Aron J. Hall
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Umesh D. Parashar
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, USA
| | - Bruce Y. Lee
- Public Health Computational and Operations Research, University of Pittsburgh School of Medicine, Pittsburgh, USA
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, USA
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, USA
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22
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Ibuka Y, Paltiel AD, Galvani AP. Impact of program scale and indirect effects on the cost-effectiveness of vaccination programs. Med Decis Making 2012; 32:442-6. [PMID: 22472916 DOI: 10.1177/0272989x12441397] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yoko Ibuka
- Yale University School of Medicine, New Haven, CT, USA (YI, ADP, APG),Hitotsubashi University, Tokyo, Japan (YI)
| | - A David Paltiel
- Yale University School of Medicine, New Haven, CT, USA (YI, ADP, APG)
| | - Alison P Galvani
- Yale University School of Medicine, New Haven, CT, USA (YI, ADP, APG)
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Pérez Velasco R, Praditsitthikorn N, Wichmann K, Mohara A, Kotirum S, Tantivess S, Vallenas C, Harmanci H, Teerawattananon Y. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics. PLoS One 2012; 7:e30333. [PMID: 22393352 PMCID: PMC3290611 DOI: 10.1371/journal.pone.0030333] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 12/14/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. METHODS The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. RESULTS 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita), the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. CONCLUSION The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost effectiveness should be readily implemented in forthcoming events that also involve the developing world. Guidelines for assessing the impact of disease and interventions should be drawn up to facilitate these studies.
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Affiliation(s)
- Román Pérez Velasco
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Muang, Nonthaburi, Thailand.
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Kapp MB. If we can force people to purchase health insurance, then let's force them to be treated too. AMERICAN JOURNAL OF LAW & MEDICINE 2012; 38:397-409. [PMID: 22696974 DOI: 10.1177/009885881203800206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Proponents of the 2010 Patient Protection and Affordable Care Act (PPACA) justify the Act's mandate that uninsured individuals either purchase a minimally defined health insurance policy (“Maintain Minimum Essential Coverage”) or pay a fine, as a necessary and proper exercise of Congress's express constitutional power to regulate interstate and foreign commerce. The United States Supreme Court will decide the correctness of that highly debatable position during its spring 2012 session.Assuming, without by any means predicting, that the validity of all parts of the PPACA—including the individual insurance mandate—is upheld, the Court's (likely multiple) opinions will constitute a major development in the evolution of American constitutional jurisprudence, even if Congress subsequently repeals specific sections of the legislation. Several commentators have expressed concern about the ramifications of a judicially validated PPACA for attempts by the government, especially through the mechanism of Comparative Effectiveness Research (CER), to limit or ration particular forms of potentially beneficial medical care for some or all patients.
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Affiliation(s)
- Marshall B Kapp
- Florida State University, Center for Innovative Collaboration in Medicine & Law, USA
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25
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Lee BY, Brown ST, Bailey RR, Zimmerman RK, Potter MA, McGlone SM, Cooley PC, Grefenstette JJ, Zimmer SM, Wheaton WD, Quinn SC, Voorhees RE, Burke DS. The benefits to all of ensuring equal and timely access to influenza vaccines in poor communities. Health Aff (Millwood) 2011; 30:1141-50. [PMID: 21653968 DOI: 10.1377/hlthaff.2010.0778] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
When influenza vaccines are in short supply, allocating vaccines equitably among different jurisdictions can be challenging. But justice is not the only reason to ensure that poorer counties have the same access to influenza vaccines as do wealthier ones. Using a detailed computer simulation model of the Washington, D.C., metropolitan region, we found that limiting or delaying vaccination of residents of poorer counties could raise the total number of influenza infections and the number of new infections per day at the peak of an epidemic throughout the region-even in the wealthier counties that had received more timely and abundant vaccine access. Among other underlying reasons, poorer counties tend to have high-density populations and more children and other higher-risk people per household, resulting in more interactions and both increased transmission of influenza and greater risk for worse influenza outcomes. Thus, policy makers across the country, in poor and wealthy areas alike, have an incentive to ensure that poorer residents have equal access to vaccines.
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Affiliation(s)
- Bruce Y Lee
- University of Pittsburgh, Pennsylvania, USA.
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