title: Cost-Effectiveness Analysis of a Television Campaign to Promote Seasonal Influenza Vaccination Among the Elderly.
abstract: BACKGROUND
  The U.S. policy goals regarding influenza vaccination coverage rate among the elderly include the increase in the coverage rate and the elimination of disparities across racial/ethnic groups.
  
  
  OBJECTIVE
  To examine the potential effectiveness of a television (TV) campaign to increase seasonal influenza vaccination among the elderly.
  
  
  METHODS
  We estimated the incremental cost-effectiveness ratio (ICER, defined as incremental cost per additionally vaccinated Medicare individual) of a hypothetical nationwide TV campaign for influenza vaccination compared with no campaign. We measured the effectiveness of the nationwide TV campaign (advertised once a week at prime time for 30 seconds) during a 17-week influenza vaccination season among four racial/ethnic elderly groups (N=39 million): non-Hispanic white (W), non-Hispanic African American (AA), English-speaking Hispanic (EH), and Spanish-speaking Hispanic (SH).
  
  
  RESULTS
  The hypothetical campaign cost was $5,960,000 (in 2012 US dollars). The estimated campaign effectiveness ranged from -1.1% (the SH group) to 1.42% (the W group), leading to an increased disparity in influenza vaccination among non-Hispanic white and non-Hispanic African American (W-AA) groups (0.6 percentage points), W-EH groups (0.1 percentage points), and W-SH groups (1.5 percentage points). The estimated ICER was $23.54 (95% confidence interval $14.21-$39.37) per additionally vaccinated Medicare elderly in a probabilistic analysis. Race/ethnicity-specific ICERs were lowest among the EH group ($22.27), followed by the W group ($22.47) and the AA group ($30.55). The nationwide TV campaign was concluded to be reasonably cost-effective compared with a benchmark intervention (with ICER $44.39 per vaccinated individual) of a school-located vaccination program. Break-even analyses estimated the maximum acceptable campaign cost to be $14,870,000, which was comparable to the benchmark ICER.
  
  
  CONCLUSIONS
  The results could justify public expenditures on the implementation of a future nationwide TV campaign, which should include multilingual campaigns, for promoting seasonal influenza vaccination.
authors: Center for Outcomes Research/Department of Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL.
authors: Minchul
authors: M
authors: Kim
authors: Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA. Electronic address: byoo@ucdavis.edu.
authors: Byung-Kwang
authors: BK
authors: Yoo
mesh_terms: D000367:Age Factors; D000375:Aging / Q000208:ethnology / Q000523:psychology*; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003663:Decision Trees; D016527:Drug Costs; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006293:Health Promotion / Q000191:economics*; D006801:Humans; D007252:Influenza Vaccines / Q000191:economics*; D007251:Influenza, Human / Q000191:economics* / Q000208:ethnology / Q000517:prevention & control*; D008389:Marketing of Health Services / Q000191:economics*; D018803:Models, Economic; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D015397:Program Evaluation; D013690:Television / Q000191:economics*; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000191:economics*
chemical_list: D007252:Influenza Vaccines
keywords: cost-effectiveness; elderly population; influenza vaccination; television campaign