Cost-effectiveness of influenza immunization in adult cancer patients in Taiwan

Abstract

The aim of this study was to investigate the efficacy of the influenza vaccine among cancer patients in Taiwan. We determined the effect of immunization on the following outcomes of disease: hospitalizations, emergency department visits, hospital outpatient visits, physician office visits, and deaths. Cost-effectiveness was analysed from the perspectives of the healthcare system and society. A decision tree was used, with estimates of disease burden and costs based on data from published and unpublished sources. The model followed 34 112 cancer patients aged 20-64 years who were registered by the Taiwan National Cancer Registry in 2002. An influenza immunization programme for the cancer population would prevent 2555 cases of all types of influenza infection, 660 of which would be serious cases involving hospitalization, emergency department visits and death. From the perspective of the healthcare system, the programme would cost US$7.7 million, providing net savings of US$5.4 million. From a societal perspective, the programme would cost US$28.6 million, providing net savings of US$22.3 million. This corresponds to savings of US$2107 and US$6338 per case averted, from healthcare and societal perspectives, respectively, as well as 110 lives saved. Lesser disease burden, greater vaccine efficacy and lower cost of hospitalizations increased cost-effectiveness. Influenza immunization for cancer patients is cost-saving and cost-effective from a healthcare and societal perspective in Taiwan. We highly recommend annual influenza vaccinations for this patient group.

Economic value of influenza vaccination

“…All but one study 39 reported the primary outcomes (item 11); only three (15%) 30,36,38 did not explain the methods used to assess health status (item 12). Of the 14 papers which clearly explained these methods, 10 (71.4%) 2,3,27,29,33,37,[39][40][41][42] also provided the details of the subjects from whom evaluations were obtained (item 13). Ten studies (50%) [27][28][29][30][34][35][36]39,41,42 did not report separately the productivity changes (item 14), and in the papers where costs and benefits were not discounted, no explanation was given except for one study 40 (item 25).…”

“…Overall, 16 out of 20 studies (80%) [1][2][3][26][27][28][29][30][31][32][34][35][36][37]40,41 were cost-effectiveness analyses (CEA) whereas four (20%) 33,36,39,41 were cost-benefit analyses (CBA). Regarding effectiveness measures, eight studies (40%) 1,[26][27][28][29]31,34,35 used quality adjusted life years (QALYs), three (15%) 32,34,38 used life years gained (LYG) and all the others chose cases of influenza, hospitalizations, influenza-related complications and deaths averted ( Table 2).…”

“…1). [1][2][3][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Of the 20 studies included, six (30%) were conducted in Europe (UK, Italy, France, Germany and Netherlands) 26,[34][35][36]38,41 and 14 (70%) [1][2][3][27][28][29][30][31][32][33]37,39,40,42 in extra-European countries, mainly in the US.…”

“…1 Although the whole population is affected, influenza morbidity and mortality rates are particularly high among individuals at increased risk of complications, such as elderly-especially those living in the communitycancer patients or patients with underlying immunosuppressive diseases. [1][2][3] Both medical expenses, due to resource use, and societal costs, from mortality and loss in productivity, are generated by this highly contagious viral infection. Vaccination for elderly and at high-risk groups is an effective strategy to prevent influenza and reduce epidemics impact and efforts have been focused on vaccine administration in most countries.…”

Influenza Among Breast Cancer Survivors in South Korea: A Nationwide Population-Based Study

“…Recently, a campaign leveraging social media platforms such as Facebook, YouTube, and blogs was used to induce behavioral changes (17). An increased influenza vaccination rate was related to a reduction in hospital admissions and a decrease in hospitalization cost for cancer survivors (18). We analyzed the frequency pattern of influenza according to time.…”