title: Modelling the return on investment of preventively vaccinating healthcare workers against pertussis.
abstract: BACKGROUND
  Healthcare workers (HCWs) are at particular risk of acquiring pertussis and transmitting the infection to high-risk susceptible patients and colleagues. In this paper, the return on investment (ROI) of preventively vaccinating HCWs against pertussis to prevent nosocomial pertussis outbreaks is estimated using a hospital ward perspective, presuming an outbreak occurs once in 10 years.
  
  
  METHODS
  Data on the pertussis outbreak on the neonatology ward in 2004 in the Academic Medical Center Amsterdam (The Netherlands) was used to calculate control costs and other outbreak related costs. The study population was: neonatology ward staff members (n = 133), parents (n = 40), neonates (n = 20), and newborns transferred to other hospitals (n = 23). ROI is presented as the amount of Euros saved in averting outbreaks by investing one Euro in preventively vaccinating HCWs. Sensitivity analysis was performed to study the robustness of the ROI. Results are presented at 2012 price level.
  
  
  RESULTS
  Total nosocomial pertussis outbreak costs were €48,682. Direct control costs (i.e. antibiotic therapy, laboratory investigation and outbreak management control) were €11,464. Other outbreak related costs (i.e. sick leave of HCWs; restrictions on the neonatology ward, savings due to reduced working force required) accounted for €37,218. Vaccination costs were estimated at €12,208. The ROI of preventively vaccinating HCWs against pertussis was 1:4, meaning 4 Euros could be saved by every Euro invested in vaccinating HCWs to avert outbreaks. ROI was sensitive to a lower vaccine price, considering direct control costs only, average length of stay of neonates on the neonatology ward, length of patient uptake restrictions, assuming no reduced work force due to ward closer and presuming more than one outbreak to occur in 10 years' time.
  
  
  CONCLUSIONS
  From a hospital ward perspective, preventive vaccination of HCWs against pertussis to prevent nosocomial pertussis outbreaks results in a positive ROI, presuming an outbreak occurs once in 10 years.
authors: Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. luqman.l.tariq@gsk.com.|GlaxoSmithKline BV, Zeist, The Netherlands. luqman.l.tariq@gsk.com.
authors: Luqman
authors: L
authors: Tariq
authors: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. M.J.J.Mangen@umcutrecht.nl.
authors: Marie-Josée J
authors: MJ
authors: Mangen
authors: Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands. A.M.Hovels@uu.nl.
authors: Anke
authors: A
authors: Hövels
authors: Academic Medical Centre Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. g.frijstein@amc.uva.nl.
authors: Gerard
authors: G
authors: Frijstein
authors: Academic Medical Centre Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. h.e.deboer@amc.uva.nl.
authors: Hero
authors: H
authors: de Boer
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D006282:Health Personnel / Q000191:economics / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D007231:Infant, Newborn; D007449:Investments; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D017059:Models, Econometric; D009426:Netherlands / Q000453:epidemiology; D010567:Pertussis Vaccine / Q000191:economics* / Q000627:therapeutic use*; D014611:Vaccination / Q000191:economics*; D014917:Whooping Cough / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D010567:Pertussis Vaccine