Summary
Scientific reviewing methods were applied to economic studies of influenza vaccination, and an economic model of influenza vaccination was developed from these primary sources. Issues arising from the secondary literature review include the quality of evidence on the effectiveness of the vaccines, the absence of a traditional population-based approach to reviewing economic data, confusion in terminology, and how to generalise, from resource data contained in primary evaluations.
Data from the literature review were summarised in terms of resource units used in the prevention and treatment of influenza. An economic model was constructed using local unit costs (from the Emilia region of Italy) and applying the data to a notional population. The model was sensitive to length of stay in hospital but not to variation in incidence of influenza, days off work or number of medical consultations. The model was predicated on and is sensitive to an estimate of 80% vaccine effectiveness. The approach is constrained by the available data, but could be more generally useful in that it allows variations in the quantity of inputs to be considered separately from variations in their values. The model may be used locally as a decision-making tool, although the method needs further development.
Similar content being viewed by others
References
Mulrow CD. Rationale for systematic reviews. In: Chalmers I and Altman DG, editors. Systematic reviews. BMJ Publishing Group, London: 1995: 1–8
Jefferson TO, Demicheli V. Is vaccination against hepatitis B efficient? A review of world literature. Health Economics 1994; 3: 25–38
Demicheli V, Casadio GP, Lanciotti G, et al. The Emilia costing study: valutazione dell’impatto economico della salmonellosiumana. Mecosan 1995; 11: 8–15
Elixhauser A, editor. Health care cost–benefit and cost–effectiveness analysis (CBAIEA). From 1979 to 1990: a bibliography. Medical Care 1993; 31 Suppl.: JS1–149
Backhouse ME, Backhouse RJ, Edey SA. Economic evaluation bibliography. Health Economics 1992; 1 Suppl.: 1–235
Perez-Tirse J, Gross PA. Review of cost–benefit analyses of influenza vaccine. Pharmacoeconomics 1992; 2: 198–206
Schoenbaum SC, McNeil BJ, Kavet J. The swine–influenza decision. N Engl J Med 1976; 295: 759–65
Anonymous. Cost–effectiveness of flu vaccine. Congressional Office of Technology Assessment. Connecticut Medicine 1982; 46
Klarman HE, Guzick D. Economics of influenza. In: Selby P, editor. Influenza: virus, vaccines and strategy. New York: Academic Press Inc. 1976: 255–70
Evans DB, Hensley MJ, O’Connor SJ. Influenza vaccination in Australia: a review of the economic evidence for policy recommendations. Med J Aust 1988; 149: 540–3
Anonymous. Prophylaxis viewed economically [translated from German]. Zahnartzliche Mitteilungen 1974; 19: 997–8
Fedson DS. The influenza vaccination demonstration project: an expanded policy goal. Infect Control Hosp Epidemiol 1990; 11 (7): 357–61
Helcl J, Gopfertova D, Heinz F. Economic relevance of influenza and other acute respiratory disease (translated from Czech). Czech Epidemiol 1988; 6: 340–9
Shevchenko LF, Sinyak KM, Sazhok RA, et al. Economic losses due to influenza and other acute respiratory illnesses and possibilities of reducing them (translated from Russian). 1974 (unpublished)
Anonymous. Economic losses in influenza epidemics (translated from Czech). Czech Ministry of Health 1982 (unpublished)
Elo O. Cost–benefit studies of vaccination in Finland. International Symposium on Immunization: benefit versus risk factors,Brussels 1978. Dev Biologic Standards 1979; 43: 419–28
Kouznetsov VS, Gouzyukina TV, Orlova ER. L’efficence economique et medico’sociale des innovations et la pratiquede la protection de la sante’. Sante Publique 1990; 33: 11–6
Fedson D. Clinical practice and public policy for influenza and pneumococcal vaccination for the elderly. Clin Geriatr Med 1992; 8: 183–99
McBean AM, Babish D, Warren JL. The impact and cost of influenza in the elderly. Arch Intern Med 1993; 153: 2105–11
Fedson OS. Influenza and pneumococcal vaccination: clinical effectiveness, value to society and variations between countries in public policies and clinical practice. 1991 (unpublishedreview)
Gasparin R. La vaccinazione antinfluenzale: stato dell’arte, esperienze e prospettive. Atti del Trentacinquesimo Congresso Nazionale di Igiene, 1992 (unpublished)
Kogan H. Flu vaccinations: are they worth the cost? Occup Health 1993; 45: 21–2
Eono P, Desfontaine M. Vaccinations en milieau militaire. Etude cout Jefficacite, 1993 (unpublished)
Hocking B. Benefits and costs of influenza immunization in the workforce. Asia Pacific Human Resource Management,November 1989; 87–93
Levy E, Levy P. La vaccination contre la grippe des personnes d’age actif (25-64 ans): une etude cout–benefice. Revue Epidemiol Sante Publique 1992; 40: 285–95
Patriarca PA, Arden NH, Koplan JP, et al. Prevention and control of type A influenza infections in nursing homes. Benefits and costs of four approaches using vaccination and amantadine. Ann Intern Med 1987; 107: 732–40
Helliwell BE, Drummond MF. The costs and benefits of preventing influenza in Ontario’s elderly. Can J Public Health 1988; 79: 175–80
Gavira FI, Lardinois R. Analisis de rentabilidad de la vacunacion antigripal en una poblacion rural (La Victoria, Cordoba). Med Clin (Barc) 1990; 94: 777–81
Maucher JM, Gambert SR. Cost–effective analysis of influenza vaccination in the elderly. Age 1990; 13: 81–5
Smith JWG, Pollard R. Vaccination against influenza: a five year study in the Post Office. J Hyg 1979; 83: 157–80
Riddiough MA, Sisk JE, Bell JC. Influenza vaccination: cost effectiveness and public policy. JAMA 1983; 249: 3189–95
Office of Technology Assessment, US Congress. Cost–effectiveness of influenza vaccination. Washington: Government Printing Office, 1982
Kavet J. A perspective on the significance of pandemic influenza. Am J Public Health 1977; 67: 1063–70
Sauras IA. Analisis economico del coste de la gripa aplicado a la provincia de Huesca. Rev Sanit Hig Publica 1987; 61: 1017–28
Koplin AN, Francis BJ, Martin RJ, et al. Administrative costs of the influenza control program of 1976-1977 in Illinois. Med Care 1979; 17: 201–9
Mullooly JP, Bennett MD, Hornbrook MRP, et al. Influenza vaccination programs for elderly persons: cost–effectiveness in a health maintenance organization. Ann Intern Med 1994; 121: 947–52
Koopmanschap MA, Rutten FH. Indirect costs in economic studies. Confronting the confusion. Pharmacoeconomics 1993; 4: 446–54
Servero CA, Fagnani F, Lafuma A. Cost–effectiveness of hepatitis Aprevention in France. Pharmacoeconomics 1995; 8 (1): 46–61
Light RJ, Pillemer D. Summing up. The science of reviewing research. London: Harvard University Press, 1984
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jefferson, T., Demicheli, V. Economic Evaluation of Influenza Vaccination and Economic Modelling. Pharmacoeconomics 9 (Suppl 3), 67–72 (1996). https://doi.org/10.2165/00019053-199600093-00015
Published:
Issue Date:
DOI: https://doi.org/10.2165/00019053-199600093-00015