Cost-benefit analysis of influenza vaccination in a public healthcare unit

Abstract

Objective Estimate the costs and benefits of influenza vaccination in a group of employees of an Italian District Health Authority, Unità Locale Socio Sanitaria (ULSS), to define a scheme of an economic evaluation to be used for other vaccination strategies. Design In an observational study conducted from December 2002 to April 2003, 107 ULSS employees, voluntarily vaccinated, were compared with 107 nonvaccinated ULSS employees matched for age, sex, and job category. The outcome of cost-benefit analysis was evaluated by checking personnel department records about absences from work and their causes, including influenza. Costs and benefits of the influenza vaccination from the ULSS point of view were calculated. Results The influenza vaccination strategy reduced absences from work by 23% and decreased the loss of working days by 30% and related cost. This difference is not significative. The ratio vaccination benefits/cost was €4.2. The advantage of vaccination is confirmed by sensitivity analysis performed on the mean cost of a working day, which showed that the benefit-cost ratio ranged from €4.5 to €11.7. Conclusions The results suggest that the influenza vaccination strategy in our sample of people was cost-saving. The economic evaluation used in this study could also be used for other vaccination strategies and in other settings.

Economic evaluations of occupational health interventions from a corporate perspective – a systematic review of methodological quality

“…Only 15 of the 34 studies (44%) met more than 50% of the quality criteria (16, 18, 30, 33, 35-37, 39, 40, 44, 46, 49), and of these, 3 met greater than 75% of the criteria (30,33,36). Six of the economic evaluations were based on data from randomized controlled trials (16,17,27,30,36,46), 16 from a controlled before-and-after design (20, 22, 24, 29, 31-33, 35, 38, 40-45, 47), seven from a uncontrolled before-and-after design (18,19,23,26,28,48,49), four from case-controls (25,34,37,39), and one from a historical cohort (21).…”

“…No included study performed a CUA. With respect to expressing the efficiency of a given intervention compared to its alternative, 65% of the financial appraisals (16, 17, 21-23, 26, 27, 29-31, 33, 34, 36-40, 43, 44, 46-48) reported the difference between monetary benefits and program costs as net savings or benefits, 32% (21,24,28,32,33,35,38,42,45,48,49) provided a benefit-to-cost ratio, 21% (18,19,27,30,38,41,45) reported the return-on-investment (ROI), 9% (20,22,26) calculated a payback period, and 6% (26, 28) noted an internal rate of return. Note that the total percentage is greater than 100% because ten studies reported two expressions each (21, 22, 26-28, 30, 33, 38, 45, 48).Twenty-eight of the studies reported cost savings or monetary benefits in favor of the intervention (16, 17, 19-22, 24, 26-31, 33-36, 38-46, 48, 49); three reported negative savings (25,37,47); two reported both negative and positive monetary benefits (18,23); and one reported both a costneutral and positive situation (32).…”

“…Mental health problems, although a significant cause of work disability, were only addressed in two studies (30,31). Table 2 provides a description of study populations, the intervention comparisons and (19,20,22,23,26,28,(31)(32)(33)(34), manufacturing (24,(35)(36)(37)(38), energy (21,(39)(40)(41), education (42,43), finance (44,45), government (27,46), transport (16,29), construction (18), defense (25), retail (17), telecommunications (47), and multiple sectors (30,48,49). With the exception of influenza, no single intervention was consistently evaluated in the other subgroups of studies addressing the same health problem.…”

“…A negative rating was given for appropriate measurement of costs if the physical units or the data collection method was not clearly stated, or if the validity of the instrument used to collect cost data was questionable (16, 17, 19-29, 32, 34, 35, 38-48). In most cases, the criterion related to the discussion of ethical and distributional issues was rated negatively because neither issue or just one of the two was addressed (16-25, 27-29, 34-36, 38, 40, 42, 45, 46, 49) and (26,31,33,37,39,41,44,48), respectively. Finally, a negative rating for the criterion related to conflict of interest was due to either lack of a declaration of (no) competing interests (17, 20, 22-24, 26, 30, 40, 48, 49) or a lack of both a declaration and information about funding (18, 19, 21, 25, 27-29, 31, 32, 34-36, 38, 39, 41-43, 45-47).…”

A network flow model for inventory management and distribution of influenza vaccines through a healthcare supply chain

“…In defining the costs of a vaccination program we adopt the approach of studies in the field of medical management (see [9], [10], [11]) and split these costs into two categories: medical and non-medical costs. Medical costs include vaccine costs, costs of service by nurses and physicians (calculated as the average service time multiplied by the average salary of nurses and doctors [9], [12]), as well as costs associated with possible vaccine shortage, which reflect the costs of additional hospitalization and outpatient services that clinics must provide as a direct result of vaccine shortage. Non-medical costs include transportation, delivery and inventory holding costs incurred by clinics and distribution centers.…”