Scenarios on costs and savings of influenza treatment and prevention for Dutch healthy working adults

Reducing the Burden of Influenza-Associated Complications with Antiviral Therapy

“…For zanamivir, evaluations have been carried out in healthy adults as well as those at higher risk because of age or chronic illness [84][85][86][87][88]; oseltamivir has also been studied in these population groups [84,[89][90][91][92][93][94], as well as in children [95,96]. These evaluations were done from the viewpoint of either the healthcare payer (measuring direct costs) or from a societal viewpoint (indirect costs), or both and, except for one study set in a long-term care facility, were based on primary care settings.…”

Influenza vaccine for healthy adult workers: An issue for health authorities or employers?

“…We found only cost-utility analyses (CUAs)-in which health outcomes include quality of life, and cost-benefit analyses (CBAs)-in which benefits too are measured in monetary terms [27]. We eventually took in five studies [17,[21][22][23]28], all built on models that required extensive recourse to assumptions (Table 1). Four were cost-utility analyses (CUAs) that included influenza seasonal costs and projected life-time benefits related to deaths averted, the fifth was a cost-benefit analysis (CBA) designed exclusively on a seasonal time horizon [23].…”

“…We eventually took in five studies [17,[21][22][23]28], all built on models that required extensive recourse to assumptions (Table 1). Four were cost-utility analyses (CUAs) that included influenza seasonal costs and projected life-time benefits related to deaths averted, the fifth was a cost-benefit analysis (CBA) designed exclusively on a seasonal time horizon [23]. The efficacy endpoints were mainly ILI episodes and deaths avoided, then transformed to Quality Adjusted Life Years (QALYs) in CUAs; only one study [28] considered laboratory-confirmed influenza instead of ILI -thus no study included ILI and serological tests as outcomes at the same time.…”

“…Bearing in mind the intrinsic limits evidenced by the initial review, we then made a deliberately conservative estimate on the Italian setting [25], inspired by the only study that applied CBA instead of CUA and chose a short-term perspective (one influenza season) [23], thus excluding mortality rates from the analysis (Table 1). We estimated the influenza-related direct and indirect costs in 50-64 subjects at low risk of complications, simulating the disease's natural history through a decision tree (Fig.…”

“…In the light of this contradictory background, the debate about the economic utility of vaccinating healthy adults is still going on. Recent studies have estimated the costs and benefits of influenza vaccination programmes for healthy working adults, most of them concluding in favour of extension to the 50-64 age group thanks to an estimated substantial drop in indirect costs [17,[19][20][21][22][23]. As the cost-effectiveness of extension is markedly influenced by the reduction of productivity costs, the analysis viewpoint could prove crucial in determining the potential benefits of vaccination for this population target.…”