Table 2.
Program Costs of Healthcare-based Quality Improvement Interventions to Increase Season Influenza Vaccination (n=29)
| Author | Time horizon | Setting | Program cost as reported by authors | Program cost reported by authors includes vaccine? | Year of costs | Standardized program costs per enrollee / per additional enrollee vaccinated (excluding vaccine cost, 2017 USD) | Economic evaluation method | Entity bearing program cost |
|---|---|---|---|---|---|---|---|---|
| Interventions focused on general populations | ||||||||
| Efforts by provider entities to promote vaccination among the patients they treat | ||||||||
| Hull 2002 | 1 season | 3 general practice clinics in England | £98.21 per 16 additional individuals vaccinated (£72.65 receptionist labor, £12.25 telephone calls, £13.31 nurse labor) | No | 2000 | $1.02 / $16.95 | Business case | Physician practice |
| Honeycutt 2007A | 1 season | 3 rural and 1 urban hospital in U.S. | $57.60 per additional individual vaccinated ($6,032–$87,534 per hospital to assess eligibility and administer vaccine) | No | 2004 | $8.52 / $119.64 | Cost analysis | Hospital |
| Honeycutt 2007B | 1 season | 2 rural and 1 urban hospital in U.S. | $411.18 per additional individual vaccinated ($27,510–$84,778 per hospital to assess eligibility and administer vaccine) | No | 2004 | $11.63 / $854.07 | Cost analysis | Hospital |
| Honeycutt 2007C | 1 season | 3 rural hospitals in U.S. | $89.70 per additional individual vaccinated ($1,840–$27,926 per hospital to assess eligibility and administer vaccine) | No | 2004 | $11.42 / $186.32 | Cost analysis | Hospital |
| Lam 2008 | 1 season | Assisted living facility in Seattle | $1,110 per 13 additional individuals vaccinated ($990 pharmacist labor, $90 medical assistant labor, $30 supplies) | No | 2004 | $24.28 / $129.80 | Business case | Assisted living facility |
| Teufel 2008 | 1 season | Hypothetical acute care hospitals in the U.S. | $13.66 per patient screened (registered nurse labor, supplies, vaccine) | Yes, $6.75 per dose | 2006 | $21.52 / $71.72 | CEA | Hospital |
| Prosser 2008 | 1 year | 5 pharmacies in U.S. | +$11.57 per additional individual vaccinated (promotion of vaccine, labor, administration, vaccine, supplies, overhead) | Yes, $7.48 per dose | 2004 | NR / $6.26 | CEA | Healthcare system |
| Patterson 2012A | 1 season | Hypothetical emergency departments in the U.S. | $34.19 per additional individual vaccinated (vaccine administration and vaccine) | Yes, not reporteda | 2008 | NR / $38.81 | CEA | Hospital |
| Patterson 2012B | 1 season | Hypothetical emergency departments in the U.S. | $34.19 per additional individual vaccinated (vaccine administration and vaccine) | Yes, not reporteda | 2008 | NR / $38.81 | CEA | Hospital |
| Herrett 2015 | 1 season | 156 general practices in the U.K. | £98,370 per 51,151 patients enrolled (£15,600 incentive payments to general practices, £3,700 letters, £1,200 software support, £53,770 research, £24,100 data costs) | No | 2013 | $3.27 / $191.48 | Cost analysis | Healthcare system |
| Michaelidis 2013A | 10 years | Hypothetical outpatient clinics in the U.S. | $2.00 per targeted patient per year | No | 2011 | $2.38 / $29.69 | CEA | Healthcare system |
| Michaelidis 2013B | 10 years | Hypothetical outpatient clinics in the U.S. | $7.62 per targeted patient per year ($2.00 patient reminders, $5.62 standing orders) | No | 2011 | $9.05 / $56.56 | CEA | Healthcare system |
| Michaelidis 2013C | 10 years | Hypothetical outpatient clinics in the U.S. | $9.61 per targeted patient per year ($2.00 patient reminders, $5.62 standing orders, $1.99 audit and feedback) | No | 2011 | $11.41 / $57.07 | CEA | Healthcare system |
| Michaelidis 2013D | 10 years | Hypothetical outpatient clinics in the U.S. | $17.84 per targeted patient per year ($2.00 patient reminders, $5.62 standing orders, $1.99 audit and feedback, and $8.23 vaccination champion) | No | 2011 | $21.19 / $105.94 | CEA | Healthcare system |
| Shoup 2015A | October of 1 season | Integrated healthcare organization in the U.S. | $0.78 per enrolled patient with postcard-only, $1.23 per enrolled patient with interactive voice response system | No | 2011 | $0.53 / $33.66 | Cost analysis | Integrated healthcare system |
| Shoup 2015B | October of 1 season | Integrated healthcare organization in the U.S. | $0.78 per enrolled patient with postcard-only, $1.93 per enrolled patient with interactive voice response system and reminder postcard | No | 2011 | $1.36 / $126.57 | Cost analysis | Integrated healthcare system |
| Stuck 2015 | 2 years | 19 primary care clinics in Switzerland | $1,017 per participant per 2 years ($961 labor, $56 administering questionnaires and feedback reports) | No | 2014 | NR / NR | Cost analysis | Clinic |
| Atkins 2015 | 1 season | 1,230 pharmacies in London | £17.13 per dose for usual care vs. £14.88 per dose for pharmacy vaccination delivery (program development and vaccine administration) | Yes, £7.37 per dose | 2013 | NR / NR | Cost analysis | Healthcare system |
| Efforts by public or private payers to promote vaccination among beneficiaries | ||||||||
| Berg 2008 | 1 season | Preferred provider organization in 5 U.S. states | +$16,000 per 26,474 household s with 1.3 members each (to produce and mail materials) | No | 2003 | $0.74 / Dominate d by the status quo | Business case | Payer |
| Terrell - Perica 2001A | 1 season | Department of Health, Hawaii | +$0.36 per letter, or +$2,350 across 6,528 study subjects (materials, labor, mailing) for letters that recommend influenza vaccination | No | 1997 | $0.73 / $27.24 | Cost analysis | Governmental body |
| Terrell - Perica 2001B | 1 season | Department of Health, Hawaii | +$0.36 per letter, or +$2,350 across 6,528 study subjects (materials, labor, mailing) for letters that recommend both influenza and pneumococcal vaccination | No | 1997 | $0.73 / $19.20 | Cost analysis | Governmental body |
| Ohkusa 2005 | 1 season | 13 large cities in Japan | +$8 subsidy per individual vaccinated equates to $50.4 million per population of 120 million nationally | Yes, $36 cost to patient | 2003 | $0.90 / $12.82 | CBA | Governmental body |
| Hoshi 2007 | 1 season | Japan | +$27 subsidy per additional individual vaccinated | Yes, $38 cost to patient | 2002 | NR / $45.00 | CEA | Governmental body |
| Interventions focused on healthcare workers | ||||||||
| Leitmeyer 2006 | 2 years | 2,000 hospitals in Germany | $45,000 across 2,000 German hospitals (to produce and distribute materials, plus 2 months labor of Public Health Scientist (cost not described) | No | 2004 | NR / NR | CEA | Governmental body |
| Lin 2012A | 1 season | 2 of 11 hospitals in a health system in Pennsylvania | $13,537–$15,471 across 2 hospitals, including oversight, clinic, vaccine, and supplies | Yes, $14.42 per dose including supplies | 2007 | $4.02 / $134.08 | Cost analysis | Healthcare system |
| Lin 2012B | 1 season | 2 of 11 hospitals in a health system in Pennsylvania | $35,392–$40,448 across 2 hospitals, including oversight, carts, clinic, vaccine, and supplies | Yes, $14.42 per dose including supplies | 2007 | $8.15 / $116.40 | Cost analysis | Healthcare system |
| Lin 2012C | 1 season | 4 of 11 hospitals in a health system in Pennsylvania | $59,869–$74,116 across 4 hospitals, including oversight, incentives, clinic, vaccine, and supplies | Yes, $14.42 per dose including supplies | 2007 | $8.04 / $89.29 | Cost analysis | Healthcare system |
| Lin 2012D | 1 season | 3 of 11 hospitals in a health system in Pennsylvania | $137,691–$170,668 across 3 hospitals, including oversight, incentives, carts, clinic, vaccine, and supplies | Yes, $14.42 per dose including supplies | 2007 | $11.03 / $183.81 | Cost analysis | Healthcare system |
| LaVela 2015 | 1 season | 2 spinal cord injury centers in Veterans Affairs hospitals | $2,098 per site, with 2 sites ($2,093 staff time, <$5.00 printed materials) | No | 2013 | NR / NR | Cost analysis | Hospital |
a
When calculating standardized program cost per enrollee and per additional enrollee vaccinated excluding vaccine cost, the 2008 Centers for Disease Control (CDC) Influenza Price List was used to estimate a vaccine private sector cost of $13.25/dose (in 2008 USD).
CEA, cost-effectiveness analysis; CBA, cost benefit analysis; NR, not reported