Medical and economic burden of influenza in the elderly population in central and eastern European countries

Abstract

Influenza affects 5–15% of the population during an epidemic. In Western Europe, vaccination of at-risk groups forms the cornerstone of influenza prevention. However, vaccination coverage of the elderly (>65 y) is often low in Central and Eastern Europe (CEE); potentially because a paucity of country-specific data limits evidence-based policy making. Therefore the medical and economic burden of influenza were estimated in elderly populations in the Czech Republic, Hungary, Kazakhstan, Poland, Romania, and Ukraine. Data covering national influenza vaccination policies, surveillance and reporting, healthcare costs, populations, and epidemiology were obtained via literature review, open-access websites and databases, and interviews with experts. A simplified model of patient treatment flow incorporating cost, population, and incidence/prevalence data was used to calculate the influenza burden per country. In the elderly, influenza represented a large burden on the assessed healthcare systems, with yearly excess hospitalization rates of ~30/100 000. Burden varied between countries and was likely influenced by population size, surveillance system, healthcare provision, and vaccine coverage. The greatest burden was found in Poland, where direct costs were over EUR 5 million. Substantial differences in data availability and quality were identified, and to fully quantify the burden of influenza in CEE, influenza reporting systems should be standardized. This study most probably underestimates the real burden of influenza, however the public health problem is recognized worldwide, and will further increase with population aging. Extending influenza vaccination of the elderly may be a cost-effective way to reduce the burden of influenza in CEE.

Costs associated with influenza-related hospitalization in the elderly

“…Our study of the direct medical costs of laboratory-confirmed influenza hospitalizations in patients aged 65 y in Spain found the mean cost per case was € 3,219, higher than the € 2,490 found in Poland, 14 the € 1,570.3 found in China, 27 or the € 1,270€ (in terms of 2011 purchasing power) reported in Italy. 28 The reduction in cost of 2.5% in vaccinated cases in our study came mainly from the reduction in the ICU stay, sparing mechanical ventilation and preventing secondary bacterial pneumonia.…”

“…Reports estimating costs have shown differences between countries, although the magnitude of the economic burden due to influenza excess hospitalizations is of great relevance everywhere. 10,[14][15][16] The aim of this study was to determine the costs associated with laboratory-confirmed influenza-related hospitalization in patients aged 65 y and assess the effect of influenza immunization in reducing costs due to hospitalization.…”

Estimating burden of influenza‐associated influenza‐like illness and severe acute respiratory infection at public healthcare facilities in Romania during the 2011/12‐2015/16 influenza seasons

“…While some estimates of the national burden of influenza are available for countries of the WHO European Region, the majority of primary study estimates come from Western Europe and no estimates are available for over half of the member states 8, 9…”

“…Except for a study on the economic influenza burden among the elderly in 6 middle‐income countries of Central and Eastern Europe in 2010/11,9 influenza burden in the Romanian population has never been estimated.…”

Pulmonary Infection

“…Molinari et al (2007) estimated that the total financial burden of the seasonal influenza infection in the US amounts to $10.4 billion a year and that the older population is responsible for 64 % of the total economic burden. It has been estimated that direct costs of influenza in the elderly population in Poland can be very high (Kovacs et al 2014). Therefore, efforts to reduce the disease's burden in the elderly population would have a substantial influence on the costs of seasonal influenza (Ryan et al 2006).…”