We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
An incremental economic evaluation of targeted and universal influenza vaccination in pregnant women.
- Authors
Skedgel C; Langley JM; MacDonald NE; Scott J; McNeil S; Skedgel, Chris; Langley, Joanne M; MacDonald, Noni E; Scott, Jeff; McNeil, Shelly
- Abstract
<bold>Objective: </bold>Pregnancy is associated with increased influenza hospitalizations and physician visits (events) in healthy women and those with co-morbidities. Annual influenza immunization is recommended for all pregnant women. Although vaccination is expected to reduce influenza-related events, the economic implications are unclear. We developed an economic model to estimate the cost-effectiveness (CE) of different vaccination strategies in Nova Scotia.<bold>Methods: </bold>A decision tree characterized the one-year costs and consequences of targeted (pregnant women with co-morbidities only) and universal (all pregnant women) vaccination strategies relative to a no-vaccination strategy. Baseline event probabilities, vaccine effectiveness, costs and quality-of-life weights were derived from individual-level Nova Scotia administrative databases, health system sources and published reports. Sensitivity analyses tested the impact of varying key parameters, including vaccine effectiveness and mode of delivery.<bold>Results: </bold>Targeted vaccination was cost-saving relative to no vaccination when delivered by public health clinics (PHC) or routine family practitioner (FP) visit. Cost per quality-adjusted life year gained by universal vaccination relative to targeted strategy was < $40,000 when delivered by PHC or routine FP visit. Net cost of universal vaccination by PHC or a routine FP visit was < $10 per pregnant woman.<bold>Conclusion: </bold>Universal vaccination of pregnant women appears cost-effective when delivered by PHC or as part of a routine FP prenatal visit. Targeted vaccination of pregnant women with co-morbidities can be cost-saving, but the possibility of higher vaccine uptake with a universal compared to a targeted strategy must be considered in addition to costs in program planning.
- Publication
Canadian Journal of Public Health, 2011, Vol 102, Issue 6, p445
- ISSN
0008-4263
- Publication type
journal article