IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v16y2015i5p471-488.html
   My bibliography  Save this article

Public health impact and cost-effectiveness of intranasal live attenuated influenza vaccination of children in Germany

Author

Listed:
  • Oliver Damm
  • Martin Eichner
  • Markus Rose
  • Markus Knuf
  • Peter Wutzler
  • Johannes Liese
  • Hagen Krüger
  • Wolfgang Greiner

Abstract

In 2011, intranasally administered live attenuated influenza vaccine (LAIV) was approved in the EU for prophylaxis of seasonal influenza in 2–17-year-old children. Our objective was to estimate the potential epidemiological impact and cost-effectiveness of an LAIV-based extension of the influenza vaccination programme to healthy children in Germany. An age-structured dynamic model of influenza transmission was developed and combined with a decision-tree to evaluate different vaccination strategies in the German health care system. Model inputs were based on published literature or were derived by expert consulting using the Delphi technique. Unit costs were drawn from German sources. Under base-case assumptions, annual routine vaccination of children aged 2–17 years with LAIV assuming an uptake of 50 % would prevent, across all ages, 16 million cases of symptomatic influenza, over 600,000 cases of acute otitis media, nearly 130,000 cases of community-acquired pneumonia, nearly 1.7 million prescriptions of antibiotics and over 165,000 hospitalisations over 10 years. The discounted incremental cost-effectiveness ratio was €1,228 per quality-adjusted life year gained from a broad third-party payer perspective (including reimbursed direct costs and specific transfer payments), when compared with the current strategy of vaccinating primarily risk groups with the conventional trivalent inactivated vaccine. Inclusion of patient co-payments and indirect costs in terms of productivity losses resulted in discounted 10-year cost savings of €3.4 billion. In conclusion, adopting universal influenza immunisation of healthy children and adolescents would lead to a substantial reduction in influenza-associated disease at a reasonable cost to the German statutory health insurance system. On the basis of the epidemiological and health economic simulation results, a recommendation of introducing annual routine influenza vaccination of children 2–17 years of age might be taken into consideration. Copyright The Author(s) 2015

Suggested Citation

  • Oliver Damm & Martin Eichner & Markus Rose & Markus Knuf & Peter Wutzler & Johannes Liese & Hagen Krüger & Wolfgang Greiner, 2015. "Public health impact and cost-effectiveness of intranasal live attenuated influenza vaccination of children in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(5), pages 471-488, June.
    • Handle: RePEc:spr:eujhec:v:16:y:2015:i:5:p:471-488
    DOI: 10.1007/s10198-014-0586-4
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s10198-014-0586-4
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10198-014-0586-4?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Martin Keech & Paul Beardsworth, 2008. "The Impact of Influenza on Working Days Lost," PharmacoEconomics, Springer, vol. 26(11), pages 911-924, November.
    2. Koopmanschap, Marc A. & Rutten, Frans F. H. & van Ineveld, B. Martin & van Roijen, Leona, 1995. "The friction cost method for measuring indirect costs of disease," Journal of Health Economics, Elsevier, vol. 14(2), pages 171-189, June.
    3. Savidan, Emmanuelle & Chevat, Catherine & Marsh, Grenville, 2008. "Economic evidence of influenza vaccination in children," Health Policy, Elsevier, vol. 86(2-3), pages 142-152, May.
    4. Joël Mossong & Niel Hens & Mark Jit & Philippe Beutels & Kari Auranen & Rafael Mikolajczyk & Marco Massari & Stefania Salmaso & Gianpaolo Scalia Tomba & Jacco Wallinga & Janneke Heijne & Malgorzata Sa, 2008. "Social Contacts and Mixing Patterns Relevant to the Spread of Infectious Diseases," PLOS Medicine, Public Library of Science, vol. 5(3), pages 1-1, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Minghuan Jiang & Yilin Gong & Yu Fang & Xuelin Yao & Liuxin Feng & Shan Zhu & Jin Peng & Xinke Shi, 2022. "Parental Preferences of Influenza Vaccination for Children in China: A National Survey with a Discrete Choice Experiment," IJERPH, MDPI, vol. 19(4), pages 1-14, February.
    2. Aparna Soni, 2020. "The effects of public health insurance on health behaviors: Evidence from the fifth year of Medicaid expansion," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1586-1605, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Maria Michela Gianino & Gianfranco Politano & Antonio Scarmozzino & Michela Stillo & Viola Amprino & Stefano Di Carlo & Alfredo Benso & Carla Maria Zotti, 2019. "Cost of Sickness Absenteeism during Seasonal Influenza Outbreaks of Medium Intensity among Health Care Workers," IJERPH, MDPI, vol. 16(5), pages 1-11, March.
    2. Naomi J Anderson & David K Bonauto & Z Joyce Fan & June T Spector, 2012. "Distribution of Influenza-Like Illness (ILI) by Occupation in Washington State, September 2009–August 2010," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-10, November.
    3. Ichino, Andrea & Favero, Carlo A. & Rustichini, Aldo, 2020. "Restarting the economy while saving lives under Covid-19," CEPR Discussion Papers 14664, C.E.P.R. Discussion Papers.
    4. Iris Arends & Ute Bültmann & Willem van Rhenen & Henk Groen & Jac J L van der Klink, 2013. "Economic Evaluation of a Problem Solving Intervention to Prevent Recurrent Sickness Absence in Workers with Common Mental Disorders," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-1, August.
    5. Simon Wieser & Bruno Horisberger & Sara Schmidhauser & Claudia Eisenring & Urs Brügger & Andreas Ruckstuhl & Jürg Dietrich & Anne Mannion & Achim Elfering & Özgür Tamcan & Urs Müller, 2011. "Cost of low back pain in Switzerland in 2005," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(5), pages 455-467, October.
    6. M. Hashem Pesaran & Cynthia Fan Yang, 2022. "Matching theory and evidence on Covid‐19 using a stochastic network SIR model," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 37(6), pages 1204-1229, September.
    7. Wei Zhong, 2017. "Simulating influenza pandemic dynamics with public risk communication and individual responsive behavior," Computational and Mathematical Organization Theory, Springer, vol. 23(4), pages 475-495, December.
    8. Houštecká, Anna & Koh, Dongya & Santaeulàlia-Llopis, Raül, 2021. "Contagion at work: Occupations, industries and human contact," Journal of Public Economics, Elsevier, vol. 200(C).
    9. Kuchler, Theresa & Russel, Dominic & Stroebel, Johannes, 2022. "JUE Insight: The geographic spread of COVID-19 correlates with the structure of social networks as measured by Facebook," Journal of Urban Economics, Elsevier, vol. 127(C).
    10. John M Drake & Tobias S Brett & Shiyang Chen & Bogdan I Epureanu & Matthew J Ferrari & Éric Marty & Paige B Miller & Eamon B O’Dea & Suzanne M O’Regan & Andrew W Park & Pejman Rohani, 2019. "The statistics of epidemic transitions," PLOS Computational Biology, Public Library of Science, vol. 15(5), pages 1-14, May.
    11. S. M. Niaz Arifin & Christoph Zimmer & Caroline Trotter & Anaïs Colombini & Fati Sidikou & F. Marc LaForce & Ted Cohen & Reza Yaesoubi, 2019. "Cost-Effectiveness of Alternative Uses of Polyvalent Meningococcal Vaccines in Niger: An Agent-Based Transmission Modeling Study," Medical Decision Making, , vol. 39(5), pages 553-567, July.
    12. Anne Tiainen & Clas Rehnberg, 2010. "The Economic Burden of Psychiatric Disorders in Sweden," International Journal of Social Psychiatry, , vol. 56(5), pages 515-526, September.
    13. Chima, Reginald Ikechukwu & Goodman, Catherine A. & Mills, Anne, 2003. "The economic impact of malaria in Africa: a critical review of the evidence," Health Policy, Elsevier, vol. 63(1), pages 17-36, January.
    14. Tilling, C & Krol, M & Tsuchiya, A & Brazier, J & van Exel, J & Brouwer, W, 2009. "The impact of losses in income due to ill health: does the EQ-5D reflect lost earnings?," MPRA Paper 29837, University Library of Munich, Germany.
    15. Luis R Carrasco & Linda K Lee & Vernon J Lee & Eng Eong Ooi & Donald S Shepard & Tun L Thein & Victor Gan & Alex R Cook & David Lye & Lee Ching Ng & Yee Sin Leo, 2011. "Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 5(12), pages 1-9, December.
    16. Bisin, Alberto & Moro, Andrea, 2022. "Spatial‐SIR with network structure and behavior: Lockdown rules and the Lucas critique," Journal of Economic Behavior & Organization, Elsevier, vol. 198(C), pages 370-388.
    17. Mirjam Kretzschmar & Rafael T Mikolajczyk, 2009. "Contact Profiles in Eight European Countries and Implications for Modelling the Spread of Airborne Infectious Diseases," PLOS ONE, Public Library of Science, vol. 4(6), pages 1-8, June.
    18. Hoeijenbos, Margreet & Bekkering, Trudy & Lamers, Leida & Hendriks, Erik & van Tulder, Maurits & Koopmanschap, Marc, 2005. "Cost-effectiveness of an active implementation strategy for the Dutch physiotherapy guideline for low back pain," Health Policy, Elsevier, vol. 75(1), pages 85-98, December.
    19. Beata Gavurova & Miriama Tarhanicova, 2021. "Methods for Estimating Avoidable Costs of Excessive Alcohol Consumption," IJERPH, MDPI, vol. 18(9), pages 1-25, May.
    20. Hanna Gyllensten & Michael Wiberg & Kristina Alexanderson & Anders Norlund & Emilie Friberg & Jan Hillert & Olivia Ernstsson & Petter Tinghög, 2018. "Costs of illness of multiple sclerosis in Sweden: a population-based register study of people of working age," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 435-446, April.

    More about this item

    Keywords

    Influenza; Vaccination; Children; Cost-effectiveness; Dynamic transmission model; Germany; I18;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:16:y:2015:i:5:p:471-488. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.