Cost-effectiveness of influenza vaccination in working-age cancer patients.
BACKGROUND
Despite recommendations to immunize all patients at an increased risk of influenza complications, the vaccine utilization among high-risk nonelderly adults remains low and its cost-effectiveness is unclear. In the current study, the authors analyzed the cost-effectiveness of influenza vaccination in working-age (ages 20-64 years) cancer patients.


METHODS
The authors developed a decision-analytic model, from the societal perspective, using epidemiologic, vaccine effectiveness, resource utilization, cost, survival, and utility data from published sources, supplemented with data collected from the authors' own institutional accounting system. Two strategies were compared: influenza vaccination of working-age cancer patients and no vaccination. The base-case patient was assumed to be a 51-year-old cancer patient (the mean age for the National Cancer Institute's Surveillance, Epidemiology, and End Results [SEER] population of working-age patients within 5 years of cancer diagnosis).


RESULTS
The effectiveness of the influenza vaccine was 6.02 quality-adjusted life-years (QALYs) at a cost of $30.10. The effectiveness of the no vaccination strategy was 6.01 QALYs at a cost of $27.86. Compared with the no vaccination strategy, the incremental cost-effectiveness ratio of vaccinating working-age cancer patients would be $224.00 per QALY gained. Using the benchmark of $50,000 per QALY, the model was only sensitive to changes in cancer survival (threshold of 2.8 months).


CONCLUSIONS
The influenza vaccine is cost-effective for working-age cancer patients with a life expectancy of >or=3 months. All working-age cancer patients who are within 5 years of cancer diagnosis and have a life expectancy of at least 3 months should be vaccinated against influenza.
Avritscher
Elenir B C
EB
Department of Biostatistics and Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. ecaramel@mdanderson.org
Cooksley
Catherine D
CD
Geraci
Jane M
JM
Bekele
Benjamin N
BN
Cantor
Scott B
SB
Rolston
Kenneth V
KV
Elting
Linda S
LS
D000328:Adult; D017677:Age Distribution; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D005260:Female; D006291:Health Policy / Q000191:economics; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000191:economics*; D007251:Influenza, Human / Q000191:economics* / Q000517:prevention & control; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D009369:Neoplasms / Q000473:pathology*; D019057:Quality-Adjusted Life Years; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000191:economics*
D007252:Influenza Vaccines