title: Cost-benefit analysis of in-hospital influenza vaccination of postpartum women.
abstract: OBJECTIVE
  To estimate the potential economic benefits associated with hospital-based postpartum influenza vaccination.
  
  
  METHODS
  We constructed a decision analysis model to estimate the potential cost benefit of this strategy from both a societal perspective and a third-party perspective. We included a hypothetical cohort of 1.47 million U.S. postpartum women, assuming an influenza season beginning September 1 and ending April 30. Probabilities and costs were derived from published literature, Centers for Disease Control and Prevention data, and expert recommendations. We used one-way and two-way sensitivity analyses. All cost estimates were inflated to year 2010 U.S. dollars and discounted at a 3% annual discount rate.
  
  
  RESULTS
  From the societal perceptive, the expected costs per vaccinated and unvaccinated mother were $328.45 and $341.02 respectively, resulting in an expected net benefit of $12.57 per vaccinated mother. The overall savings in the cohort were predicted to range from $3.69 to $14.75 million, depending on the vaccination coverage rate. This strategy would be cost-beneficial, holding all other variables to the base case, if the annual maternal influenza attack rate is more than 2.8%, influenza vaccine efficacy is more than 47%, or if vaccine acquisition and administration cost per dose are less than $32.78. The strategy would not generate net savings from the third-party perspective. Sensitivity analyses were robust, but disease incidence and vaccine efficacy were important drivers.
  
  
  CONCLUSIONS
  Our model suggests that postpartum influenza vaccination is a cost-beneficial approach for prevention of maternal and infantile influenza from a societal perspective.
  
  
  METHODS
  III.
authors.affiliation: Leonard Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California, USA.
authors.forename: Yao
authors.initials: Y
authors.lastname: Ding
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Zangwill
authors.forename: Joel W
authors.initials: JW
authors.lastname: Hay
authors.forename: Norma J
authors.initials: NJ
authors.lastname: Allred
authors.forename: Sylvia H
authors.initials: SH
authors.lastname: Yeh
mesh_terms: D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D007251:Influenza, Human / Q000191:economics* / Q000517:prevention & control*; D007349:Insurance, Health, Reimbursement / Q000191:economics; D017059:Models, Econometric; D049590:Postpartum Period; D011247:Pregnancy; D011336:Probability; D014481:United States; D014611:Vaccination / Q000191:economics*