title: Community pharmacists as immunization advocates. Cost-effectiveness of a cue to influenza vaccination.
abstract: To assess the cost-effectiveness of a cue to influenza vaccination provided by community pharmacists, a decision tree was constructed of the consequences of implementing a pharmacy-based vaccine-advocacy program, based on experience gained in an experiment involving three community pharmacies in Durham County, North Carolina. The model used morbidity and mortality assumptions derived from the infectious-disease literature and cost assumptions based on 1990-91 Medicare Part A and Part B reimbursement costs. This analysis suggests that if Medicare reimbursed pharmacists for advising 100,000 patients at risk to accept influenza vaccine through vaccine-advocacy messages, for an apparent expenditure of $110,000, the increased rate of influenza vaccinations would avert 139 hospitalizations and 63 deaths, and actually yield Medicare a net savings of $280,588. These calculations probably underestimate the benefit to society of a pharmacy-based vaccine-advocacy program, because only direct costs to the single government agency were computed and no cost was attributed to death or lost earnings.
authors.affiliation: Department of Pharmacy, Walter Reed Army Medical Center, Washington, DC 20307-5001.
authors.forename: J D
authors.initials: JD
authors.lastname: Grabenstein
authors.forename: A G
authors.initials: AG
authors.lastname: Hartzema
authors.forename: H A
authors.initials: HA
authors.lastname: Guess
authors.forename: W P
authors.initials: WP
authors.lastname: Johnston
authors.forename: B E
authors.initials: BE
authors.lastname: Rittenhouse
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D006801:Humans; D007114:Immunization / Q000191:economics*; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000191:economics / Q000517:prevention & control; D007349:Insurance, Health, Reimbursement; D008875:Middle Aged; D015233:Models, Statistical; D010342:Patient Acceptance of Health Care; D010595:Pharmacists; D012680:Sensitivity and Specificity; D014481:United States
chemical_list: D007252:Influenza Vaccines