Economic assessment of a high-dose versus a standard-dose influenza vaccine in the US Veteran population: Estimating the impact on hospitalization cost for cardio-respiratory disease

Robertus van Aalst; Ellyn M Russo; Nabin Neupane; Salaheddin M Mahmud; Vincent Mor; Jan Wilschut; Ayman Chit; Maarten Postma; Yinong Young-Xu

doi:10.1016/j.vaccine.2019.06.066

Economic assessment of a high-dose versus a standard-dose influenza vaccine in the US Veteran population: Estimating the impact on hospitalization cost for cardio-respiratory disease

Vaccine. 2019 Jul 26;37(32):4499-4503. doi: 10.1016/j.vaccine.2019.06.066. Epub 2019 Jun 28.

Authors

Robertus van Aalst¹, Ellyn M Russo², Nabin Neupane², Salaheddin M Mahmud³, Vincent Mor⁴, Jan Wilschut⁵, Ayman Chit⁶, Maarten Postma⁷, Yinong Young-Xu⁸

Affiliations

¹ Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Regional Epidemiology and Health Economics, Sanofi Pasteur, Swiftwater, PA, USA. Electronic address: Rob.VanAalst@sanofi.com.
² Clinical Epidemiology Program, Veterans Affairs Medical Center, White River Junction, Vermont, USA.
³ Department of Community Health Sciences, College of Medicine, University of Manitoba, Winnipeg, MB, Canada; George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg Regional Health Authority, Winnipeg, MB, Canada.
⁴ Brown University, School of Public Health, Department of Health Services, Policy and Practice, USA; Providence VA Medical Center, Center of Innovation in Long-Term Services and Supports, USA.
⁵ Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
⁶ Regional Epidemiology and Health Economics, Sanofi Pasteur, Swiftwater, PA, USA; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
⁷ Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Unit of PharmacoTherapy, -Epidemiology & -Economics (PTE2), University of Groningen, Department of Pharmacy, Groningen, the Netherlands; Department of Economics, Econometrics & Finance, University of Groningen, Faculty of Economics & Business, Groningen, the Netherlands.
⁸ Clinical Epidemiology Program, Veterans Affairs Medical Center, White River Junction, Vermont, USA; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.

PMID: 31262590
DOI: 10.1016/j.vaccine.2019.06.066

Abstract

Objective: To compare the economic impact of high-dose trivalent (HD) versus standard-dose trivalent (SD) influenza vaccination on direct medical costs for cardio-respiratory hospitalizations in adults aged 65 years or older enrolled in the United States (US) Veteran's Health Administration (VHA).

Methods: Leveraging a relative vaccine effectiveness study of HD versus SD over five respiratory seasons (2010/11 through 2014/15), we collected cost data for healthcare provided to the same study population both at VHA and through Medicare services. Our economic assessment compared the costs of vaccination and hospital care for patients experiencing acute cardio-vascular or respiratory illness.

Results: We analyzed 3.5 million SD and 158,636 HD person-seasons. The average cost of HD and SD vaccination was $23.48 (95% CI: $21.29 - $25.85) and $12.21 (95% CI: $11.49 - $13.00) per recipient, respectively, while the hospitalization rates for cardio-respiratory disease in HD and SD recipients were 0.114 (95% CI: 0.108-0.121) and 0.132 (95% CI: 0.132-0.133) per person-season, respectively. Attributing the average cost per hospitalization of $11,796 (95% CI: $11,685 - $11,907) to the difference in hospitalization rates, we estimated savings attributable to HD to be $202 (95% CI: $115 - $280) per vaccinated recipient.

Conclusions: For the five-season period of 2010/11 through 2014/15, HD influenza vaccination was associated with net cost savings due to fewer hospitalizations, and therefore lower direct medical costs, for cardio-respiratory disease as compared to SD influenza vaccination in the senior US VHA population.

Keywords: Economic assessment; High-dose vaccine; Influenza.

Publication types

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

MeSH terms

Aged
Cost Savings / economics
Cost-Benefit Analysis
Female
Hospitalization / economics*
Humans
Influenza Vaccines / economics*
Male
Respiratory Tract Diseases / economics*
Respiratory Tract Diseases / immunology
Retrospective Studies
Vaccination / economics*
Veterans

Substances

Influenza Vaccines