Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.

<h4>Background</h4>In July 2000, the province of Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free seasonal influenza vaccines for the entire population. This is the first large-scale program of its kind worldwide. The objective of this study wa...

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Autores principales:	Beate Sander, Jeffrey C Kwong, Chris T Bauch, Andreas Maetzel, Allison McGeer, Janet M Raboud, Murray Krahn
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2010
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/7d6acc047fdf47b4b8c39a43a13b520f
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spelling	oai:doaj.org-article:7d6acc047fdf47b4b8c39a43a13b520f2021-12-02T19:55:51ZEconomic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.1549-12771549-167610.1371/journal.pmed.1000256https://doaj.org/article/7d6acc047fdf47b4b8c39a43a13b520f2010-04-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20386727/pdf/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>In July 2000, the province of Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free seasonal influenza vaccines for the entire population. This is the first large-scale program of its kind worldwide. The objective of this study was to conduct an economic appraisal of Ontario's UIIP compared to a targeted influenza immunization program (TIIP).<h4>Methods and findings</h4>A cost-utility analysis using Ontario health administrative data was performed. The study was informed by a companion ecological study comparing physician visits, emergency department visits, hospitalizations, and deaths between 1997 and 2004 in Ontario and nine other Canadian provinces offering targeted immunization programs. The relative change estimates from pre-2000 to post-2000 as observed in other provinces were applied to pre-UIIP Ontario event rates to calculate the expected number of events had Ontario continued to offer targeted immunization. Main outcome measures were quality-adjusted life years (QALYs), costs in 2006 Canadian dollars, and incremental cost-utility ratios (incremental cost per QALY gained). Program and other costs were drawn from Ontario sources. Utility weights were obtained from the literature. The incremental cost of the program per QALY gained was calculated from the health care payer perspective. Ontario's UIIP costs approximately twice as much as a targeted program but reduces influenza cases by 61% and mortality by 28%, saving an estimated 1,134 QALYs per season overall. Reducing influenza cases decreases health care services cost by 52%. Most cost savings can be attributed to hospitalizations avoided. The incremental cost-effectiveness ratio is Can$10,797/QALY gained. Results are most sensitive to immunization cost and number of deaths averted.<h4>Conclusions</h4>Universal immunization against seasonal influenza was estimated to be an economically attractive intervention.Beate SanderJeffrey C KwongChris T BauchAndreas MaetzelAllison McGeerJanet M RaboudMurray KrahnPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 7, Iss 4, p e1000256 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Beate Sander Jeffrey C Kwong Chris T Bauch Andreas Maetzel Allison McGeer Janet M Raboud Murray Krahn Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
description	<h4>Background</h4>In July 2000, the province of Ontario, Canada, initiated a universal influenza immunization program (UIIP) to provide free seasonal influenza vaccines for the entire population. This is the first large-scale program of its kind worldwide. The objective of this study was to conduct an economic appraisal of Ontario's UIIP compared to a targeted influenza immunization program (TIIP).<h4>Methods and findings</h4>A cost-utility analysis using Ontario health administrative data was performed. The study was informed by a companion ecological study comparing physician visits, emergency department visits, hospitalizations, and deaths between 1997 and 2004 in Ontario and nine other Canadian provinces offering targeted immunization programs. The relative change estimates from pre-2000 to post-2000 as observed in other provinces were applied to pre-UIIP Ontario event rates to calculate the expected number of events had Ontario continued to offer targeted immunization. Main outcome measures were quality-adjusted life years (QALYs), costs in 2006 Canadian dollars, and incremental cost-utility ratios (incremental cost per QALY gained). Program and other costs were drawn from Ontario sources. Utility weights were obtained from the literature. The incremental cost of the program per QALY gained was calculated from the health care payer perspective. Ontario's UIIP costs approximately twice as much as a targeted program but reduces influenza cases by 61% and mortality by 28%, saving an estimated 1,134 QALYs per season overall. Reducing influenza cases decreases health care services cost by 52%. Most cost savings can be attributed to hospitalizations avoided. The incremental cost-effectiveness ratio is Can$10,797/QALY gained. Results are most sensitive to immunization cost and number of deaths averted.<h4>Conclusions</h4>Universal immunization against seasonal influenza was estimated to be an economically attractive intervention.
format	article
author	Beate Sander Jeffrey C Kwong Chris T Bauch Andreas Maetzel Allison McGeer Janet M Raboud Murray Krahn
author_facet	Beate Sander Jeffrey C Kwong Chris T Bauch Andreas Maetzel Allison McGeer Janet M Raboud Murray Krahn
author_sort	Beate Sander
title	Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
title_short	Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
title_full	Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
title_fullStr	Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
title_full_unstemmed	Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.
title_sort	economic appraisal of ontario's universal influenza immunization program: a cost-utility analysis.
publisher	Public Library of Science (PLoS)
publishDate	2010
url	https://doaj.org/article/7d6acc047fdf47b4b8c39a43a13b520f
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Economic appraisal of Ontario's Universal Influenza Immunization Program: a cost-utility analysis.

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