Economic evaluation of an influenza immunization strategy of healthy children.
Identifieur interne : 000312 ( Main/Exploration ); précédent : 000311; suivant : 000313Economic evaluation of an influenza immunization strategy of healthy children.
Auteurs : Meghann Gregg [Oman] ; Gordon Blackhouse [Canada] ; Mark Loeb [Canada] ; Ron Goeree [Canada]Source :
- International journal of technology assessment in health care [ 1471-6348 ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
- méthodes : Analyse coût-bénéfice.
- prévention et contrôle : Grippe humaine.
- économie : Programmes de vaccination.
- Adolescent, Calendrier vaccinal, Canada, Enfant, Enfant d'âge préscolaire, Humains, Économie médicale.
- Wicri :
- geographic : Canada.
English descriptors
- KwdEn :
- MESH :
- geographic : Canada.
- economics : Immunization Programs.
- methods : Cost-Benefit Analysis.
- prevention & control : Influenza, Human.
- Adolescent, Child, Child, Preschool, Economics, Medical, Humans, Immunization Schedule.
Abstract
OBJECTIVES
Vaccinating healthy children is proposed as a strategy to produce a herd effect and protect vulnerable groups. The Hutterite Influenza Prevention Study investigated this strategy, comparing communities with or without childhood influenza immunization programs. There are costs associated with vaccination therefore there may be a trade-off between these costs and the benefits of avoiding influenza cases. This evaluation estimates the cost-effectiveness of immunizing only healthy children in preventing cases of influenza within entire communities.
METHODS
Effect data and resource utilization were collected during the trial. Cost data were collected from payer, literature and Internet sources. A two-stage bootstrap (TSB) with shrinkage correction was used to estimate average costs and effects. The incremental cost effectiveness ratio (ICER) and sample uncertainty around this estimate were calculated from the TSB results.
RESULTS
Mean costs per patient for the treatment and control arms were $69.07 and $32.66 (difference $36.41). Mean number of influenza cases for the treatment and control arms were 0.04 and 0.27 (difference 0.23). ICER was $164.12 ($28.38, $2767.75) per case of influenza averted.
CONCLUSIONS
Immunizing healthy children for influenza is more costly, yet more effective than no immunization in preventing cases in the sample. At a cost of $164.12 to prevent a case of influenza, immunizing healthy children to protect all community members may be considered costeffective. Estimated results are conservative as the influenza season was mild and the sample population was healthy. In a more severe season with a less healthy population the ICER is expected to decrease.
DOI: 10.1017/S0266462314000397
PubMed: 25412647
Affiliations:
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McMaster</orgName><country>Canada</country><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Loeb, Mark" sort="Loeb, Mark" uniqKey="Loeb M" first="Mark" last="Loeb">Mark Loeb</name><affiliation wicri:level="4"><nlm:affiliation>McMaster University,Department of Pathology and Molecular Medicine.</nlm:affiliation><orgName type="university">Université McMaster</orgName><country>Canada</country><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Goeree, Ron" sort="Goeree, Ron" uniqKey="Goeree R" first="Ron" last="Goeree">Ron Goeree</name><affiliation wicri:level="4"><nlm:affiliation>McMaster University,Clinical Epidemiology and Biostatistics.</nlm:affiliation><orgName type="university">Université McMaster</orgName><country>Canada</country><placeName><settlement 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wicri:level="1"><nlm:affiliation>Health Economics Department,GlaxoSmithKline Vaccines,Wavre,Belgiummeglgregg@gmail.com.</nlm:affiliation><country wicri:rule="url">Oman</country><wicri:regionArea>Health Economics Department,GlaxoSmithKline Vaccines,Wavre</wicri:regionArea><wicri:noRegion>Wavre</wicri:noRegion></affiliation></author><author><name sortKey="Blackhouse, Gordon" sort="Blackhouse, Gordon" uniqKey="Blackhouse G" first="Gordon" last="Blackhouse">Gordon Blackhouse</name><affiliation wicri:level="4"><nlm:affiliation>McMaster University,Clinical Epidemiology and Biostatistics;PATH Research Institute.</nlm:affiliation><orgName type="university">Université McMaster</orgName><country>Canada</country><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Loeb, Mark" sort="Loeb, Mark" uniqKey="Loeb M" first="Mark" last="Loeb">Mark Loeb</name><affiliation wicri:level="4"><nlm:affiliation>McMaster University,Department of Pathology and Molecular Medicine.</nlm:affiliation><orgName type="university">Université McMaster</orgName><country>Canada</country><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Goeree, Ron" sort="Goeree, Ron" uniqKey="Goeree R" first="Ron" last="Goeree">Ron Goeree</name><affiliation wicri:level="4"><nlm:affiliation>McMaster University,Clinical Epidemiology and Biostatistics.</nlm:affiliation><orgName type="university">Université McMaster</orgName><country>Canada</country><placeName><settlement type="city">Hamilton (Ontario)</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">International journal of technology assessment in health care</title><idno type="eISSN">1471-6348</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Canada (MeSH)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Cost-Benefit Analysis (methods)</term><term>Economics, Medical (MeSH)</term><term>Humans (MeSH)</term><term>Immunization Programs (economics)</term><term>Immunization Schedule (MeSH)</term><term>Influenza, Human (prevention & control)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Analyse coût-bénéfice (méthodes)</term><term>Calendrier vaccinal (MeSH)</term><term>Canada (MeSH)</term><term>Enfant (MeSH)</term><term>Enfant d'âge préscolaire (MeSH)</term><term>Grippe humaine (prévention et contrôle)</term><term>Humains (MeSH)</term><term>Programmes de vaccination (économie)</term><term>Économie médicale (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Canada</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Immunization Programs</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Cost-Benefit Analysis</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Analyse coût-bénéfice</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Programmes de vaccination</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Child</term><term>Child, Preschool</term><term>Economics, Medical</term><term>Humans</term><term>Immunization Schedule</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Calendrier vaccinal</term><term>Canada</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Humains</term><term>Économie médicale</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Canada</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>Vaccinating healthy children is proposed as a strategy to produce a herd effect and protect vulnerable groups. The Hutterite Influenza Prevention Study investigated this strategy, comparing communities with or without childhood influenza immunization programs. There are costs associated with vaccination therefore there may be a trade-off between these costs and the benefits of avoiding influenza cases. This evaluation estimates the cost-effectiveness of immunizing only healthy children in preventing cases of influenza within entire communities.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Effect data and resource utilization were collected during the trial. Cost data were collected from payer, literature and Internet sources. A two-stage bootstrap (TSB) with shrinkage correction was used to estimate average costs and effects. The incremental cost effectiveness ratio (ICER) and sample uncertainty around this estimate were calculated from the TSB results.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Mean costs per patient for the treatment and control arms were $69.07 and $32.66 (difference $36.41). Mean number of influenza cases for the treatment and control arms were 0.04 and 0.27 (difference 0.23). ICER was $164.12 ($28.38, $2767.75) per case of influenza averted.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Immunizing healthy children for influenza is more costly, yet more effective than no immunization in preventing cases in the sample. At a cost of $164.12 to prevent a case of influenza, immunizing healthy children to protect all community members may be considered costeffective. Estimated results are conservative as the influenza season was mild and the sample population was healthy. In a more severe season with a less healthy population the ICER is expected to decrease.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25412647</PMID><DateCompleted><Year>2015</Year><Month>11</Month><Day>23</Day></DateCompleted><DateRevised><Year>2015</Year><Month>02</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1471-6348</ISSN><JournalIssue CitedMedium="Internet"><Volume>30</Volume><Issue>4</Issue><PubDate><Year>2014</Year><Month>Oct</Month></PubDate></JournalIssue><Title>International journal of technology assessment in health care</Title><ISOAbbreviation>Int J Technol Assess Health Care</ISOAbbreviation></Journal><ArticleTitle>Economic evaluation of an influenza immunization strategy of healthy children.</ArticleTitle><Pagination><MedlinePgn>394-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1017/S0266462314000397</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">Vaccinating healthy children is proposed as a strategy to produce a herd effect and protect vulnerable groups. The Hutterite Influenza Prevention Study investigated this strategy, comparing communities with or without childhood influenza immunization programs. There are costs associated with vaccination therefore there may be a trade-off between these costs and the benefits of avoiding influenza cases. This evaluation estimates the cost-effectiveness of immunizing only healthy children in preventing cases of influenza within entire communities.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Effect data and resource utilization were collected during the trial. Cost data were collected from payer, literature and Internet sources. A two-stage bootstrap (TSB) with shrinkage correction was used to estimate average costs and effects. The incremental cost effectiveness ratio (ICER) and sample uncertainty around this estimate were calculated from the TSB results.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Mean costs per patient for the treatment and control arms were $69.07 and $32.66 (difference $36.41). Mean number of influenza cases for the treatment and control arms were 0.04 and 0.27 (difference 0.23). ICER was $164.12 ($28.38, $2767.75) per case of influenza averted.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Immunizing healthy children for influenza is more costly, yet more effective than no immunization in preventing cases in the sample. At a cost of $164.12 to prevent a case of influenza, immunizing healthy children to protect all community members may be considered costeffective. Estimated results are conservative as the influenza season was mild and the sample population was healthy. In a more severe season with a less healthy population the ICER is expected to decrease.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gregg</LastName><ForeName>Meghann</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Health Economics Department,GlaxoSmithKline Vaccines,Wavre,Belgiummeglgregg@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blackhouse</LastName><ForeName>Gordon</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>McMaster University,Clinical Epidemiology and Biostatistics;PATH Research Institute.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loeb</LastName><ForeName>Mark</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>McMaster University,Department of Pathology and Molecular Medicine.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goeree</LastName><ForeName>Ron</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>McMaster University,Clinical Epidemiology and Biostatistics.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2014</Year><Month>11</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Int J Technol Assess Health Care</MedlineTA><NlmUniqueID>8508113</NlmUniqueID><ISSNLinking>0266-4623</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002170" MajorTopicYN="N" Type="Geographic">Canada</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003362" MajorTopicYN="N">Cost-Benefit Analysis</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004470" MajorTopicYN="N">Economics, Medical</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017589" MajorTopicYN="N">Immunization Programs</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007115" MajorTopicYN="Y">Immunization Schedule</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Adolescent</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2014</Year><Month>11</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2014</Year><Month>11</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25412647</ArticleId><ArticleId IdType="pii">S0266462314000397</ArticleId><ArticleId IdType="doi">10.1017/S0266462314000397</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li><li>Oman</li></country><region><li>Ontario</li></region><settlement><li>Hamilton (Ontario)</li></settlement><orgName><li>Université McMaster</li></orgName></list><tree><country name="Oman"><noRegion><name sortKey="Gregg, Meghann" sort="Gregg, Meghann" uniqKey="Gregg M" first="Meghann" last="Gregg">Meghann Gregg</name></noRegion></country><country name="Canada"><region name="Ontario"><name sortKey="Blackhouse, Gordon" sort="Blackhouse, Gordon" uniqKey="Blackhouse G" first="Gordon" last="Blackhouse">Gordon Blackhouse</name></region><name sortKey="Goeree, Ron" sort="Goeree, Ron" uniqKey="Goeree R" first="Ron" last="Goeree">Ron Goeree</name><name sortKey="Loeb, Mark" sort="Loeb, Mark" uniqKey="Loeb M" first="Mark" last="Loeb">Mark Loeb</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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