Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.

<h4>Background</h4>Pandemic influenza A(H1N1) (pH1N1) was first identified in North America in April 2009. Vaccination against pH1N1 commenced in the U.S. in October 2009 and continued through January 2010. The objective of this study was to evaluate the cost-effectiveness of pH1N1 vacci...

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Autores principales:	Lisa A Prosser, Tara A Lavelle, Anthony E Fiore, Carolyn B Bridges, Carrie Reed, Seema Jain, Kelly M Dunham, Martin I Meltzer
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/64229d7428d643dfbad14ee936b701e9
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spelling	oai:doaj.org-article:64229d7428d643dfbad14ee936b701e92021-11-18T06:49:04ZCost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.1932-620310.1371/journal.pone.0022308https://doaj.org/article/64229d7428d643dfbad14ee936b701e92011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21829456/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Pandemic influenza A(H1N1) (pH1N1) was first identified in North America in April 2009. Vaccination against pH1N1 commenced in the U.S. in October 2009 and continued through January 2010. The objective of this study was to evaluate the cost-effectiveness of pH1N1 vaccination.<h4>Methodology</h4>A computer simulation model was developed to predict costs and health outcomes for a pH1N1 vaccination program using inactivated vaccine compared to no vaccination. Probabilities, costs and quality-of-life weights were derived from emerging primary data on pH1N1 infections in the US, published and unpublished data for seasonal and pH1N1 illnesses, supplemented by expert opinion. The modeled target population included hypothetical cohorts of persons aged 6 months and older stratified by age and risk. The analysis used a one-year time horizon for most endpoints but also includes longer-term costs and consequences of long-term sequelae deaths. A societal perspective was used. Indirect effects (i.e., herd effects) were not included in the primary analysis. The main endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted life year (QALY) gained. Sensitivity analyses were conducted.<h4>Results</h4>For vaccination initiated prior to the outbreak, pH1N1 vaccination was cost-saving for persons 6 months to 64 years under many assumptions. For those without high risk conditions, incremental cost-effectiveness ratios ranged from $8,000-$52,000/QALY depending on age and risk status. Results were sensitive to the number of vaccine doses needed, costs of vaccination, illness rates, and timing of vaccine delivery.<h4>Conclusions</h4>Vaccination for pH1N1 for children and working-age adults is cost-effective compared to other preventive health interventions under a wide range of scenarios. The economic evidence was consistent with target recommendations that were in place for pH1N1 vaccination. We also found that the delays in vaccine availability had a substantial impact on the cost-effectiveness of vaccination.Lisa A ProsserTara A LavelleAnthony E FioreCarolyn B BridgesCarrie ReedSeema JainKelly M DunhamMartin I MeltzerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 7, p e22308 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Lisa A Prosser Tara A Lavelle Anthony E Fiore Carolyn B Bridges Carrie Reed Seema Jain Kelly M Dunham Martin I Meltzer Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.
description	<h4>Background</h4>Pandemic influenza A(H1N1) (pH1N1) was first identified in North America in April 2009. Vaccination against pH1N1 commenced in the U.S. in October 2009 and continued through January 2010. The objective of this study was to evaluate the cost-effectiveness of pH1N1 vaccination.<h4>Methodology</h4>A computer simulation model was developed to predict costs and health outcomes for a pH1N1 vaccination program using inactivated vaccine compared to no vaccination. Probabilities, costs and quality-of-life weights were derived from emerging primary data on pH1N1 infections in the US, published and unpublished data for seasonal and pH1N1 illnesses, supplemented by expert opinion. The modeled target population included hypothetical cohorts of persons aged 6 months and older stratified by age and risk. The analysis used a one-year time horizon for most endpoints but also includes longer-term costs and consequences of long-term sequelae deaths. A societal perspective was used. Indirect effects (i.e., herd effects) were not included in the primary analysis. The main endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted life year (QALY) gained. Sensitivity analyses were conducted.<h4>Results</h4>For vaccination initiated prior to the outbreak, pH1N1 vaccination was cost-saving for persons 6 months to 64 years under many assumptions. For those without high risk conditions, incremental cost-effectiveness ratios ranged from $8,000-$52,000/QALY depending on age and risk status. Results were sensitive to the number of vaccine doses needed, costs of vaccination, illness rates, and timing of vaccine delivery.<h4>Conclusions</h4>Vaccination for pH1N1 for children and working-age adults is cost-effective compared to other preventive health interventions under a wide range of scenarios. The economic evidence was consistent with target recommendations that were in place for pH1N1 vaccination. We also found that the delays in vaccine availability had a substantial impact on the cost-effectiveness of vaccination.
format	article
author	Lisa A Prosser Tara A Lavelle Anthony E Fiore Carolyn B Bridges Carrie Reed Seema Jain Kelly M Dunham Martin I Meltzer
author_facet	Lisa A Prosser Tara A Lavelle Anthony E Fiore Carolyn B Bridges Carrie Reed Seema Jain Kelly M Dunham Martin I Meltzer
author_sort	Lisa A Prosser
title	Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.
title_short	Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.
title_full	Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.
title_fullStr	Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.
title_full_unstemmed	Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.
title_sort	cost-effectiveness of 2009 pandemic influenza a(h1n1) vaccination in the united states.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/64229d7428d643dfbad14ee936b701e9
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Cost-effectiveness of 2009 pandemic influenza A(H1N1) vaccination in the United States.

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