The value of influenza vaccination: an assessment from the economic point of view

Background: Influenza epidemics are responsible for considerable\r\nmortality and morbidity rates, especially among elderly and high risk\r\ngroups, and vaccination is the main effective strategy for primary\r\nprevention.\r\nObjectives: The aim of the study was to analyze the economic\r\nimpact of influenza vaccination with a particular focus on elderly and\r\nhigh risk groups, independently from age.\r\nMethods: A search of cost-effectiveness and cost-utility analyses of\r\ninfluenza vaccination in comparison with no intervention was carried\r\nout on PubMed from January 1990 to May 2011. Economic analyses\r\nwere considered eligible only if they addressed elderly and high risk\r\ngroups. The quality of selected articles was assessed through\r\nDrummond’s checklist.\r\nResults: Sixteen cost-effectiveness analyses and four cost-benefit\r\nanalyses were selected, with a quality judged fairly good. Influenza\r\nvaccination appeared to be cost-effective and sometimes cost-saving\r\namong elderly, also in terms of deaths averted and years of life gained.\r\nAmong children at risk, vaccination was shown to be cost-saving from\r\nthe societal perspective and less costly than other preventive\r\nmeasures, with a cost-benefit ratio of 6.4. Among high risk groups\r\nvaccination was cost-effective in all studies but one with respect to\r\npatients younger than 65: for adult cancer patients it was either costeffective\r\n(Incremental Cost-Effectiveness Ratio of US$224.00 per\r\nQuality Adjusted Life Years gained) or cost-saving, averting total costs\r\nby US$ 2,107 and US$ 6,338 from the health care and societal\r\nperspective respectively.\r\nDiscussion and implications: Influenza vaccination has a very\r\nhigh economic value, as it allows to allocate resources efficiently and\r\nto guarantee a better health state also by avoiding severe complications\r\namong elderly and high risk groups. Anyway, the standardization of\r\nmethods of evaluation would permit the comparability and transferability of results of different studies. The saving of indirect\r\ncosts should be also considered in addressing economic implications\r\nin Public Health.