Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
Identifieur interne : 000674 ( Main/Exploration ); précédent : 000673; suivant : 000675Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
Auteurs : Beate Sander [Canada] ; Jeffrey C. Kwong ; Chris T. Bauch ; Andreas Maetzel ; Allison Mcgeer ; Janet M. Raboud ; Murray KrahnSource :
- PLoS medicine [ 1549-1676 ] ; 2010.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Analyse coût-bénéfice (méthodes), Canada (MeSH), Enfant (MeSH), Enfant d'âge préscolaire (MeSH), Humains (MeSH), Jeune adulte (MeSH), Ontario (MeSH), Programmes de vaccination (économie), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Vaccins antigrippaux (usage thérapeutique), Vaccins antigrippaux (économie).
- MESH :
- méthodes : Analyse coût-bénéfice.
- usage thérapeutique : Vaccins antigrippaux.
- économie : Programmes de vaccination, Vaccins antigrippaux.
- Adolescent, Adulte, Adulte d'âge moyen, Canada, Enfant, Enfant d'âge préscolaire, Humains, Jeune adulte, Ontario, Sujet âgé, Sujet âgé de 80 ans ou plus.
- Wicri :
- geographic : Canada.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Canada (MeSH), Child (MeSH), Child, Preschool (MeSH), Cost-Benefit Analysis (methods), Humans (MeSH), Immunization Programs (economics), Influenza Vaccines (economics), Influenza Vaccines (therapeutic use), Middle Aged (MeSH), Ontario (MeSH), Young Adult (MeSH).
- MESH :
- chemical , economics : Influenza Vaccines.
- chemical , therapeutic use : Influenza Vaccines.
- geographic : Canada, Ontario.
- economics : Immunization Programs.
- methods : Cost-Benefit Analysis.
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Humans, Middle Aged, Young Adult.
Abstract
BACKGROUND
In July 2000, the province of Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free seasonal influenza vaccines for the entire population. This is the first large-scale program of its kind worldwide. The objective of this study was to conduct an economic appraisal of Ontario's UIIP compared to a targeted influenza immunization program (TIIP).
METHODS AND FINDINGS
A cost-utility analysis using Ontario health administrative data was performed. The study was informed by a companion ecological study comparing physician visits, emergency department visits, hospitalizations, and deaths between 1997 and 2004 in Ontario and nine other Canadian provinces offering targeted immunization programs. The relative change estimates from pre-2000 to post-2000 as observed in other provinces were applied to pre-UIIP Ontario event rates to calculate the expected number of events had Ontario continued to offer targeted immunization. Main outcome measures were quality-adjusted life years (QALYs), costs in 2006 Canadian dollars, and incremental cost-utility ratios (incremental cost per QALY gained). Program and other costs were drawn from Ontario sources. Utility weights were obtained from the literature. The incremental cost of the program per QALY gained was calculated from the health care payer perspective. Ontario's UIIP costs approximately twice as much as a targeted program but reduces influenza cases by 61% and mortality by 28%, saving an estimated 1,134 QALYs per season overall. Reducing influenza cases decreases health care services cost by 52%. Most cost savings can be attributed to hospitalizations avoided. The incremental cost-effectiveness ratio is Can$10,797/QALY gained. Results are most sensitive to immunization cost and number of deaths averted.
CONCLUSIONS
Universal immunization against seasonal influenza was estimated to be an economically attractive intervention.
DOI: 10.1371/journal.pmed.1000256
PubMed: 20386727
PubMed Central: PMC2850382
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Raboud</name></author><author><name sortKey="Krahn, Murray" sort="Krahn, Murray" uniqKey="Krahn M" first="Murray" last="Krahn">Murray Krahn</name></author></analytic><series><title level="j">PLoS medicine</title><idno type="eISSN">1549-1676</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Canada (MeSH)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Cost-Benefit Analysis (methods)</term><term>Humans (MeSH)</term><term>Immunization Programs (economics)</term><term>Influenza Vaccines (economics)</term><term>Influenza Vaccines (therapeutic use)</term><term>Middle Aged (MeSH)</term><term>Ontario (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Analyse coût-bénéfice (méthodes)</term><term>Canada (MeSH)</term><term>Enfant (MeSH)</term><term>Enfant d'âge préscolaire (MeSH)</term><term>Humains (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Ontario (MeSH)</term><term>Programmes de vaccination (économie)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Vaccins antigrippaux (usage thérapeutique)</term><term>Vaccins antigrippaux (économie)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="economics" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Canada</term><term>Ontario</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="usage thérapeutique" xml:lang="fr"><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Programmes de vaccination</term><term>Vaccins antigrippaux</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Child</term><term>Child, Preschool</term><term>Humans</term><term>Middle Aged</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Canada</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Humains</term><term>Jeune adulte</term><term>Ontario</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</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>BACKGROUND</b></p><p>In July 2000, the province of Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free seasonal influenza vaccines for the entire population. This is the first large-scale program of its kind worldwide. The objective of this study was to conduct an economic appraisal of Ontario's UIIP compared to a targeted influenza immunization program (TIIP).</p></div><div type="abstract" xml:lang="en"><p><b>METHODS AND FINDINGS</b></p><p>A cost-utility analysis using Ontario health administrative data was performed. The study was informed by a companion ecological study comparing physician visits, emergency department visits, hospitalizations, and deaths between 1997 and 2004 in Ontario and nine other Canadian provinces offering targeted immunization programs. The relative change estimates from pre-2000 to post-2000 as observed in other provinces were applied to pre-UIIP Ontario event rates to calculate the expected number of events had Ontario continued to offer targeted immunization. Main outcome measures were quality-adjusted life years (QALYs), costs in 2006 Canadian dollars, and incremental cost-utility ratios (incremental cost per QALY gained). Program and other costs were drawn from Ontario sources. Utility weights were obtained from the literature. The incremental cost of the program per QALY gained was calculated from the health care payer perspective. Ontario's UIIP costs approximately twice as much as a targeted program but reduces influenza cases by 61% and mortality by 28%, saving an estimated 1,134 QALYs per season overall. Reducing influenza cases decreases health care services cost by 52%. Most cost savings can be attributed to hospitalizations avoided. The incremental cost-effectiveness ratio is Can$10,797/QALY gained. Results are most sensitive to immunization cost and number of deaths averted.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Universal immunization against seasonal influenza was estimated to be an economically attractive intervention.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20386727</PMID><DateCompleted><Year>2010</Year><Month>07</Month><Day>22</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1549-1676</ISSN><JournalIssue CitedMedium="Internet"><Volume>7</Volume><Issue>4</Issue><PubDate><Year>2010</Year><Month>Apr</Month><Day>06</Day></PubDate></JournalIssue><Title>PLoS medicine</Title><ISOAbbreviation>PLoS Med.</ISOAbbreviation></Journal><ArticleTitle>Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.</ArticleTitle><Pagination><MedlinePgn>e1000256</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pmed.1000256</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">In July 2000, the province of Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free seasonal influenza vaccines for the entire population. This is the first large-scale program of its kind worldwide. The objective of this study was to conduct an economic appraisal of Ontario's UIIP compared to a targeted influenza immunization program (TIIP).</AbstractText><AbstractText Label="METHODS AND FINDINGS" NlmCategory="RESULTS">A cost-utility analysis using Ontario health administrative data was performed. The study was informed by a companion ecological study comparing physician visits, emergency department visits, hospitalizations, and deaths between 1997 and 2004 in Ontario and nine other Canadian provinces offering targeted immunization programs. The relative change estimates from pre-2000 to post-2000 as observed in other provinces were applied to pre-UIIP Ontario event rates to calculate the expected number of events had Ontario continued to offer targeted immunization. Main outcome measures were quality-adjusted life years (QALYs), costs in 2006 Canadian dollars, and incremental cost-utility ratios (incremental cost per QALY gained). Program and other costs were drawn from Ontario sources. Utility weights were obtained from the literature. The incremental cost of the program per QALY gained was calculated from the health care payer perspective. Ontario's UIIP costs approximately twice as much as a targeted program but reduces influenza cases by 61% and mortality by 28%, saving an estimated 1,134 QALYs per season overall. Reducing influenza cases decreases health care services cost by 52%. Most cost savings can be attributed to hospitalizations avoided. The incremental cost-effectiveness ratio is Can$10,797/QALY gained. Results are most sensitive to immunization cost and number of deaths averted.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Universal immunization against seasonal influenza was estimated to be an economically attractive intervention.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sander</LastName><ForeName>Beate</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. bsander@uhnres.utoronto.ca</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kwong</LastName><ForeName>Jeffrey C</ForeName><Initials>JC</Initials></Author><Author ValidYN="Y"><LastName>Bauch</LastName><ForeName>Chris T</ForeName><Initials>CT</Initials></Author><Author ValidYN="Y"><LastName>Maetzel</LastName><ForeName>Andreas</ForeName><Initials>A</Initials></Author><Author 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IdType="pubmed">18438789</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Bauch, Chris T" sort="Bauch, Chris T" uniqKey="Bauch C" first="Chris T" last="Bauch">Chris T. Bauch</name><name sortKey="Krahn, Murray" sort="Krahn, Murray" uniqKey="Krahn M" first="Murray" last="Krahn">Murray Krahn</name><name sortKey="Kwong, Jeffrey C" sort="Kwong, Jeffrey C" uniqKey="Kwong J" first="Jeffrey C" last="Kwong">Jeffrey C. Kwong</name><name sortKey="Maetzel, Andreas" sort="Maetzel, Andreas" uniqKey="Maetzel A" first="Andreas" last="Maetzel">Andreas Maetzel</name><name sortKey="Mcgeer, Allison" sort="Mcgeer, Allison" uniqKey="Mcgeer A" first="Allison" last="Mcgeer">Allison Mcgeer</name><name sortKey="Raboud, Janet M" sort="Raboud, Janet M" uniqKey="Raboud J" first="Janet M" last="Raboud">Janet M. Raboud</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Sander, Beate" sort="Sander, Beate" uniqKey="Sander B" first="Beate" last="Sander">Beate Sander</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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