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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cost-Effectiveness of Healthcare Worker Pneumococcal Polysaccharide Vaccination During Pandemic Influenza</title><author><name sortKey="Smith, Kenneth J" sort="Smith, Kenneth J" uniqKey="Smith K" first="Kenneth J." last="Smith">Kenneth J. Smith</name></author><author><name sortKey="Raymund, Mahlon" sort="Raymund, Mahlon" uniqKey="Raymund M" first="Mahlon" last="Raymund">Mahlon Raymund</name></author><author><name sortKey="Nowalk, Mary Patricia" sort="Nowalk, Mary Patricia" uniqKey="Nowalk M" first="Mary Patricia" last="Nowalk">Mary Patricia Nowalk</name></author><author><name sortKey="Roberts, Mark S" sort="Roberts, Mark S" uniqKey="Roberts M" first="Mark S." last="Roberts">Mark S. Roberts</name></author><author><name sortKey="Zimmerman, Richard K" sort="Zimmerman, Richard K" uniqKey="Zimmerman R" first="Richard K." last="Zimmerman">Richard K. Zimmerman</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20225915</idno><idno type="pmc">2918289</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2918289</idno><idno type="RBID">PMC:2918289</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">000568</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000568</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cost-Effectiveness of Healthcare Worker Pneumococcal Polysaccharide Vaccination During Pandemic Influenza</title><author><name sortKey="Smith, Kenneth J" sort="Smith, Kenneth J" uniqKey="Smith K" first="Kenneth J." last="Smith">Kenneth J. Smith</name></author><author><name sortKey="Raymund, Mahlon" sort="Raymund, Mahlon" uniqKey="Raymund M" first="Mahlon" last="Raymund">Mahlon Raymund</name></author><author><name sortKey="Nowalk, Mary Patricia" sort="Nowalk, Mary Patricia" uniqKey="Nowalk M" first="Mary Patricia" last="Nowalk">Mary Patricia Nowalk</name></author><author><name sortKey="Roberts, Mark S" sort="Roberts, Mark S" uniqKey="Roberts M" first="Mark S." last="Roberts">Mark S. Roberts</name></author><author><name sortKey="Zimmerman, Richard K" sort="Zimmerman, Richard K" uniqKey="Zimmerman R" first="Richard K." last="Zimmerman">Richard K. Zimmerman</name></author></analytic><series><title level="j">The American journal of managed care</title><idno type="ISSN">1088-0224</idno><idno type="eISSN">1936-2692</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">In prior influenza pandemics, pneumococcal complications of influenza have caused substantial morbidity and mortality. The usefulness and cost-effectiveness of pneumococcal vaccination for healthcare workers during an influenza pandemic is unknown.</p></sec><sec id="S2"><title>Study Design</title><p id="P2">Markov modeling was used to estimate the cost-effectiveness of pneumococcal polysaccharide vaccination (PPV) in previously unvaccinated healthcare workers during an influenza pandemic.</p></sec><sec sec-type="methods" id="S3"><title>Methods</title><p id="P3">Invasive pneumococcal disease (IPD) incidence rates were incorporated into the model, assuming that IPD events occurred at twice the usual rate during the year of pandemic influenza. Both societal and hospital perspectives were examined. Assumptions were that: pneumococcal disease transmission from healthcare worker to patient did not occur, heightened IPD risk occurred for only 1 year, and PPV did not prevent noninvasive pneumonia, all of which potentially bias against vaccination.</p></sec><sec id="S4"><title>Results</title><p id="P4">From a societal standpoint, pneumococcal vaccination of healthcare workers during an influenza pandemic is economically reasonable, costing $2,935 per quality adjusted life year gained; results were robust to variation in multiple sensitivity analyses. However, from the hospital perspective vaccinating healthcare workers was expensive, costing $1,676 per employee absence day avoided, given an IPD risk that, though increased, would still remain <1%.</p></sec><sec id="S5"><title>Conclusion</title><p id="P5">Vaccinating all healthcare workers to protect against pneumococcal disease during a pandemic influenza outbreak is likely to be economically reasonable from the societal standpoint. However, pneumococcal vaccination is expensive from the hospital perspective, which might prevent implementation of a PPV program unless it is externally subsidized.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9613960</journal-id><journal-id journal-id-type="pubmed-jr-id">21348</journal-id><journal-id journal-id-type="nlm-ta">Am J Manag Care</journal-id><journal-title>The American journal of managed care</journal-title><issn pub-type="ppub">1088-0224</issn><issn pub-type="epub">1936-2692</issn></journal-meta><article-meta><article-id pub-id-type="pmid">20225915</article-id><article-id pub-id-type="pmc">2918289</article-id><article-id pub-id-type="manuscript">NIHMS206864</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Cost-Effectiveness of Healthcare Worker Pneumococcal Polysaccharide Vaccination During Pandemic Influenza</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Kenneth J.</given-names></name><degrees>MD, MS</degrees></contrib><contrib contrib-type="author"><name><surname>Raymund</surname><given-names>Mahlon</given-names></name><degrees>PhD</degrees></contrib><contrib contrib-type="author"><name><surname>Nowalk</surname><given-names>Mary Patricia</given-names></name><degrees>PhD, RD</degrees></contrib><contrib contrib-type="author"><name><surname>Roberts</surname><given-names>Mark S.</given-names></name><degrees>MD, MPP</degrees></contrib><contrib contrib-type="author"><name><surname>Zimmerman</surname><given-names>Richard K.</given-names></name><degrees>MD, MPH</degrees></contrib><aff id="A1">From the Section of Decision Sciences and Clinical Systems Modeling (KJS, MSR) and the Department of Family Medicine and Clinical Epidemiology (RKZ, MR, MPN), School of Medicine and the Department of Behavioral and Community Health Sciences (RKZ), Graduate School of Public Health, University of Pittsburgh, Pittsburgh PA</aff></contrib-group><author-notes><corresp id="cor1">Address correspondence to: Kenneth J. Smith, MD, MS, 200 Meyran Ave, Suite 200, Pittsburgh, PA 15213; Telephone: 412/647-4794; Fax: 412/246-6954; <email>smithkj2@upmc.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>25</day><month>5</month><year>2010</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2010</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>9</month><year>2010</year></pub-date><volume>16</volume><issue>3</issue><fpage>200</fpage><lpage>206</lpage><abstract><sec id="S1"><title>Objective</title><p id="P1">In prior influenza pandemics, pneumococcal complications of influenza have caused substantial morbidity and mortality. The usefulness and cost-effectiveness of pneumococcal vaccination for healthcare workers during an influenza pandemic is unknown.</p></sec><sec id="S2"><title>Study Design</title><p id="P2">Markov modeling was used to estimate the cost-effectiveness of pneumococcal polysaccharide vaccination (PPV) in previously unvaccinated healthcare workers during an influenza pandemic.</p></sec><sec sec-type="methods" id="S3"><title>Methods</title><p id="P3">Invasive pneumococcal disease (IPD) incidence rates were incorporated into the model, assuming that IPD events occurred at twice the usual rate during the year of pandemic influenza. Both societal and hospital perspectives were examined. Assumptions were that: pneumococcal disease transmission from healthcare worker to patient did not occur, heightened IPD risk occurred for only 1 year, and PPV did not prevent noninvasive pneumonia, all of which potentially bias against vaccination.</p></sec><sec id="S4"><title>Results</title><p id="P4">From a societal standpoint, pneumococcal vaccination of healthcare workers during an influenza pandemic is economically reasonable, costing $2,935 per quality adjusted life year gained; results were robust to variation in multiple sensitivity analyses. However, from the hospital perspective vaccinating healthcare workers was expensive, costing $1,676 per employee absence day avoided, given an IPD risk that, though increased, would still remain <1%.</p></sec><sec id="S5"><title>Conclusion</title><p id="P5">Vaccinating all healthcare workers to protect against pneumococcal disease during a pandemic influenza outbreak is likely to be economically reasonable from the societal standpoint. However, pneumococcal vaccination is expensive from the hospital perspective, which might prevent implementation of a PPV program unless it is externally subsidized.</p></sec></abstract><kwd-group><kwd>pneumococcal polysaccharide vaccine</kwd><kwd>healthcare workers</kwd><kwd>pandemic influenza</kwd><kwd>cost-effectiveness</kwd><kwd>secondary pneumococcal pneumonia</kwd></kwd-group><contract-num rid="AI1">R01 AI076256-02
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