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The effect of influenza and pneumococcal vaccination in the elderly on health service utilisation and costs: a claims data-based cohort study

Author

Listed:
  • Josephine Storch

    (Jena University Hospital
    Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg)

  • Carolin Fleischmann-Struzek

    (Jena University Hospital)

  • Norman Rose

    (Jena University Hospital)

  • Thomas Lehmann

    (Jena University Hospital)

  • Anna Mikolajetz

    (Jena University Hospital)

  • Srikanth Maddela

    (Jena University Hospital)

  • Mathias W. Pletz

    (Jena University Hospital)

  • Christina Forstner

    (Jena University Hospital
    Medical University of Vienna)

  • Ole Wichmann

    (Immunization Unit, Robert Koch Institute)

  • Julia Neufeind

    (Immunization Unit, Robert Koch Institute)

  • Monique Vogel

    (Jena University Hospital)

  • Konrad Reinhart

    (Jena University Hospital
    Jena University Hospital
    BIH Visiting Professor/Charité Foundation, Charité Universitätsmedizin Berlin)

  • Horst Christian Vollmar

    (Jena University Hospital
    Ruhr-University Bochum)

  • Antje Freytag

    (Jena University Hospital)

Abstract

Background To date, cost-effectiveness of influenza and pneumococcal vaccinations was assumed in several health economic modelling studies, but confirmation by real-world data is sparse. The aim of this study is to assess the effects on health care utilisation and costs in the elderly using real-world data on both, outpatient and inpatient care. Methods Retrospective community-based cohort study with 138,877 individuals aged ≥ 60 years, insured in a large health insurance fund in Thuringia (Germany). We assessed health care utilisation and costs due to influenza- or pneumococcal-associated diseases, respiratory infections, and sepsis in 2015 and 2016. Individuals were classified into four groups according to their vaccination status from 2008 to 2016 (none, both, or either only influenza or pneumococcal vaccination). Inverse probability weighting based on 236 pre-treatment covariates was used to adjust for potential indication and healthy vaccinee bias. Results Influenza vaccination appeared as cost-saving in 2016, with lower disease-related health care costs of − €178.87 [95% CI − €240.03;− €117.17] per individual (2015: − €50.02 [95% CI − €115.48;€15.44]). Cost-savings mainly resulted from hospital inpatient care, whereas higher costs occurred for outpatient care. Overall cost savings of pneumococcal vaccination were not statistically significant in both years, but disease-related outpatient care costs were lower in pneumococci-vaccinated individuals in 2015 [− €9.43; 95% CI − €17.56;− €1.30] and 2016 [− €12.93; 95% CI − €25.37;− €0.48]. Although we used complex adjustment, residual bias cannot be completely ruled out. Conclusion Influenza and pneumococcal vaccination in the elderly can be cost-saving in selective seasons and health care divisions. As cost effects vary, interpretation of findings is partly challenging.

Suggested Citation

  • Josephine Storch & Carolin Fleischmann-Struzek & Norman Rose & Thomas Lehmann & Anna Mikolajetz & Srikanth Maddela & Mathias W. Pletz & Christina Forstner & Ole Wichmann & Julia Neufeind & Monique Vog, 2022. "The effect of influenza and pneumococcal vaccination in the elderly on health service utilisation and costs: a claims data-based cohort study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 67-80, February.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:1:d:10.1007_s10198-021-01343-8
    DOI: 10.1007/s10198-021-01343-8
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    References listed on IDEAS

    as
    1. Livio Garattini & Anna Padula, 2011. "To model or not to model: lessons from two vaccinations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(3), pages 189-191, June.
    2. Dara Lee Luca & Jeffrey C. Kwong & Anna Chu & Beate Sander & Ryan O’Reilly & Allison J. McGeer & David E. Bloom, "undated". "Impact of Pneumococcal Vaccination on Pneumonia Hospitalizations and Related Costs in Ontario: A Population-Based Ecological Study," Mathematica Policy Research Reports b82168da0b9e48858e78256f7, Mathematica Policy Research.
    3. Stuart G Nicholls & Pauline Quach & Erik von Elm & Astrid Guttmann & David Moher & Irene Petersen & Henrik T Sørensen & Liam Smeeth & Sinéad M Langan & Eric I Benchimol, 2015. "The REporting of Studies Conducted Using Observational Routinely-Collected Health Data (RECORD) Statement: Methods for Arriving at Consensus and Developing Reporting Guidelines," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-18, May.
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