Author: Das Gupta R. Guest J.F.
Publisher: Adis International
ISSN: 1170-7690
Source: PharmacoEconomics, Vol.20, Iss.7, 2002-01, pp. : 475-484
Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.
Abstract
Objectives: To model the economic impact of introducing an occupational vaccination programme for influenza with an inactivated influenza subunit vaccine (Influvac) in the UK.Design and setting: Using published sources, a decision tree was constructed which modelled the costs and benefits of introducing an influenza vaccine in a business in the UK from the perspective of an employer.Study participants and interventions: The model considered the implementation of an occupational vaccination programme with Influvac in a business employing 1000 normal healthy adults earning the national average wage in the UK. The model assumed that 95% of employees would be absent from work after contracting influenza for a mean of 5 days and that the level of productivity would be reduced by 60% for one day by 85% of sick employees returning to work.Main outcome measures and results: The expected probability of an employee being absent from work following an influenza vaccination would be reduced from 5.7 to 1.8% when the incidence of influenza in the community is 6%. Accordingly, if all 1000 employees were vaccinated, a business would be expected to reduce absenteeism from work attributable to an influenza outbreak by 220 days. Moreover, the expected return on every pound invested by an employer would be 1.03, 3.09 and 5.15 (2000 values) when the annual incidence of influenza in the community is 2, 6 and 10%, respectively.Conclusions: Implementation of an occupational vaccination programme with Influvac would be expected to reduce the incidence of influenza among a workforce leading to less absenteeism from work and averted lost productivity. Even if the incidence of influenza was as low as 2% it may be a worthwhile investment for UK employers to vaccinate their employees with Influvac.@SUMMARY ORA = Influenza is a common respiratory illness that has been estimated to affect up to 20% of the population annually. In a non-epidemic year in the UK, influenza results in approximately 9000 hospitalisations in people aged over 65 yearsand between 3000 and 4000 deaths. In a serious epidemic year, such as 1989/1990, mortality can be as high as 30 000 deaths. Additionally, influenza has a substantial impact on direct and indirect costs. In 1982/1983, there were an estimated 6.4 million working days lost in the UK associated with certified influenza illness.These data clearly demonstrate that influenza is a serious public health problem, which requires all possible prevention and control measures to minimise its impact.The efficacy and effectiveness of currently available inactivated influenza vaccines have been proven beyond doubt. Influenza vaccines have been shown to be effective in reducing the incidence of infection and associated morbidity and mortality, and most European countries have a governmentally-sponsored programme for vaccinating high-risk groups. A recent review on 15 years of experience with an inactivated influenza subunit vaccine (Influvac) showed safety and efficacy data derived from marketing experience and clinical studies. During the period 1982 to 1996, 87.5 million doses of the subunit vaccine were distributed and only 273 adverse events were reported and filed in the post-marketing surveillance database. Of these 273 adverse events, 121 were rated as serious, but in most cases no cause-effect relationship with the vaccine was established. The data from clinical studies showed that 56% of vaccinees reported no reactions at all after vaccination. From 3000 subjects, 95% reported no or only slight inconvenience and 4% reported moderate inconvenience after vaccination. Serological protection rates of 65 to 78% were reported in a meta-analysis of clinical data in the above-mentioned review.Influenza vaccination among people over 60 years of age is both clinically effective and cost effective in reducing the incidence of infection and associated illness, hospitalisation and mortality when the infectious and vaccine strains are closely related.Present UK guidance on influenza immunisation recommends that it should be provided for those of any age with chronic respiratory disease, heart disease, renal disease, diabetes mellitus and immunosuppression due to disease or treatment. It is also recommended for those over 74 years of age and all those living in long-stay residential accommodation. However, little emphasis is given to working age adults receiving the vaccine. Moreover, while it may be clinically beneficial to vaccinate healthy adults under 65 years of age, it has been reported that there are few economic benefits to the healthcare system and society. Against this background, this study aimed to model the economic impact of introducing an occupational vaccination programme in terms of the net costs to an employer in the UK.
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