The potential economic value of influenza vaccination for healthcare workers in The Netherlands

Abstract

BackgroundDespite the clinical evidence, influenza vaccination coverage of healthcare workers remains low. To assess the health economic value of implementing an influenza immunization program among healthcare workers (HCW) in University Medical Centers (UMCs) in the Netherlands, a cost‐benefit model was developed using a societal perspective.Methods/PatientsThe model was based on a trial performed among all UMCs in the Netherlands that included both hospital staff and patients admitted to the pediatrics and internal medicine departments. The model structure and parameters estimates were based on the trial and complemented with literature research, and the impact of uncertainty explored with sensitivity analyses.ResultsIn a base‐case scenario without vaccine coverage, influenza‐related annual costs were estimated at € 410 815 for an average UMC with 8000 HCWs and an average occupancy during the influenza period of 6000 hospitalized patients. Of these costs, 82% attributed to the HCWs and 18% were patient‐related. With a vaccination coverage of 15.47%, the societal program’s savings were € 2861 which corresponds to a saving of € 270.53 per extended hospitalization. Univariate sensitivity analyses show that the results are most sensitive to changes in the model parameters vaccine effectiveness in reducing influenza‐like illness (ILI) and the vaccination‐related costs.ConclusionIn addition to the decreased burden of patient morbidity among hospitalized patients, the effects of the hospital immunization program slightly outweigh the economic investments. These outcomes may support healthcare policymakers’ recommendations about the influenza vaccination program for healthcare workers.

Inclusion of Safety-Related Issues in Economic Evaluations for Seasonal Influenza Vaccines: A Systematic Review

“…The majority of the evaluated studies reported their outcomes using CUA [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. Other types of economic evaluation considered were CEAs ( N = 11) [ 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ], CBA (11 studies) [ 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ], or combining more than one type (10 studies) [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ,…”

“…Most studies reflected the societal perspective ( N = 18) [ 30 , 34 , 35 , 36 , 41 , 42 , 43 , 45 , 46 , 47 , 55 , 57 , 63 , 64 , 67 , 73 , 78 , 79 ]. Fifteen studies evaluated the issue in question from more than one perspective, combining the societal perspective with another perspective [ 27 , 32 , 33 , 37 , 38 , 39 , 40 , 44 , 49 , 52 , 56 , 59 , 66 , 68 , 77 ]. The rest of the studies considered either a healthcare provider perspective [ 29 , 31 , 50 , 58 , 72 , 75 ], employer perspective [ 60 , 65 ], patient perspective [ 51 ], family perspective [ 69 ], school perspective [ 70 ], net monetary benefit perspective [ 71 ], or medical insurance perspective [ 61 ].…”

“…Population characteristics showed that analyses focusing on children were most frequent ( N = 18) [ 27 , 28 , 30 , 33 , 37 , 42 , 47 , 48 , 49 , 52 , 55 , 56 , 67 , 69 , 70 , 76 , 77 , 78 ], followed by analyses of the elderly ( N = 12) [ 35 , 38 , 39 , 40 , 46 , 50 , 53 , 57 , 58 , 62 , 72 , 75 ], pregnant/postpartum women and infants ( N = 7) [ 29 , 31 , 32 , 34 , 41 , 59 , 74 ] and other groups of adults (workforce, risk groups) [ 36 , 43 , 44 , 45 , 51 , 54 , 60 , 61 , 63 , 64 , 65 , 66 , 68 ,…”

“…The frequencies of occurrence of AEFIs were expressed through probabilities, incidence, rates, or relative risk mentioned in 35 of the included studies [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 49 , 51 , 52 , 55 , 56 , 57 , 59 , 61 , 63 , 64 , 68 , 72 , 73 , 75 , 76 , 77 , 78 ]. The majority of them took 1% probability of occurrence of AEFIs, considering a consultation with a physician or systemic AEFIs [ 28 , 31 , 43 , 44 , 49 , 59 , 72 , 76 ].…”

“…Such derived data are further used while performing economic evaluations on the comparing interventions. Of the same height, study-based (trial/observational/survey) economic evaluation, included in our review [ 35 , 43 , 44 , 52 , 53 , 54 , 56 , 57 , 61 , 62 , 63 , 65 , 66 , 68 , 70 , 71 , 72 , 77 , 78 , 92 ], gave more explicit information on the AEFI than the model-based studies, which are more likely to account for parameter assumptions.…”