According to new research, offering influenza vaccination to patients at a pediatric emergency department (ED) lessens the financial and patient burden of pediatric influenza. For the project, Rebecca Hart, MD, a pediatric emergency medicine fellow at the University of Louisville, and colleagues utilized TreeAge Pro software to analyze the cost effectiveness of four different strategies for offering the flu vaccine in the pediatric ED. A Healio report notes that the strategies they assessed consisted of offering the vaccine to four groups: all patients, only patients aged 0 to 5 years, patients at ‘high-risk’ for influenza-related complications according to CDC guidelines or no patients.
The researchers reviewed literature to identify baseline factors including the likelihood of influenza illness and baseline vaccination, the cost of the vaccine, outpatient visits for influenza, and influenza-related hospitalizations and death. In addition, the team used information on parents’ willingness to vaccinate their children in the ED from a prior study and performed a sensitivity analysis to determine the influence of uncertainties among input variables such as influenza prevalence, vaccine price and effectiveness, and costs of complications, reports Healio.
Hart says, “ Using this information, the software determined that the most cost-effective strategy was to offer the vaccine to all patients at a cost of $93.33 per case of influenza averted. When compared to offering the vaccine to no one, offering to everyone saved an estimated $27 per patient and averted an additional 27 cases of flu [per 1,000 patients].”
“In our ED, we had not regularly offered flu vaccines to patients through the 2013-2014 season. My research project in residency revolved around surveying families to determine whether families would be interested or willing to receive influenza vaccine during an ED visit for a non-critical illness,” explains Hart. “We found that many families who intended to become vaccinated during the influenza season did not go on to become vaccinated, and that at least 50% of those families were interested in being able to obtain influenza vaccine in the pediatric ED. That led us to consider whether regularly offering the vaccine would be feasible.”
The results also showed that offering vaccination to all patients yielded an estimated incremental cost-effectiveness ratio of $1,030.11 per additional case of influenza averted compared with offering vaccination to no patients, according to Hart. She adds the cost per QALY saved was estimated at $55,258, which is in keeping with accepted standards for pediatric interventions.
The Healio report indicates that cost- effectiveness of influenza vaccination in the pediatric ED was based on a societal standpoint, which suggested “the strategy of offering vaccine to everyone had a net monetary benefit under a wide variety of conditions in sensitivity analyses,” Hart says.