Battelle Memorial Institute, Public Health and Advanced Analytics, Seattle, WA, USA.
Berry Technology Solutions, Atlanta, GA, USA.
Prev Med. 2019 Sep;126:105734. doi: 10.1016/j.ypmed.2019.05.022. Epub 2019 May 29.
The Centers for Disease Control and Prevention recommend annual influenza vaccination of persons ≥6 months old. However, in 2016-17, only 43.3% of U.S. adults reported receiving an influenza vaccination. Limited awareness about the cost-effectiveness (CE) or the economic value of influenza vaccination may contribute to low vaccination coverage. In 2017, we conducted a literature review to survey estimates of the CE of influenza vaccination of adults compared to no vaccination. We also summarized CE estimates of other common preventive interventions that are recommended for adults by the U.S. Preventive Services Task Force. Results are presented as costs in US$2015 per quality-adjusted life-year (QALY) saved. Among adults aged 18-64, the CE of influenza vaccination ranged from $8000 to $39,000 per QALY. Assessments for adults aged ≥65 yielded lower CE ratios, ranging from being cost-saving to $15,300 per QALY. Influenza vaccination was cost-saving to $85,000 per QALY for pregnant women in moderate or severe influenza seasons and $260,000 per QALY in low-incidence seasons. For other preventive interventions, CE estimates ranged from cost-saving to $170,000 per QALY saved for breast cancer screening among women aged 50-74, from cost-saving to $16,000 per QALY for colorectal cancer screening, and from $27,000 to $600,000 per QALY for hypertension screening and treatment. Influenza vaccination in adults appears to have a similar CE profile as other commonly utilized preventive services for adults. Efforts to improve adult vaccination should be considered by adult-patient providers, healthcare systems and payers given the health and economic benefits of influenza vaccination.
美国疾病控制与预防中心（CDC）建议，年龄在 6 个月及以上的人群每年接种流感疫苗。然而，在 2016-17 年，仅有 43.3%的美国成年人报告称接种了流感疫苗。人们对流感疫苗的成本效益（CE）或经济价值的认知有限，可能导致疫苗接种率较低。2017 年，我们进行了文献综述，调查了与不接种疫苗相比，成人接种流感疫苗的 CE 估计值。我们还总结了美国预防服务工作组（USPSTF）推荐的其他常见成人预防干预措施的 CE 估计值。结果以 2015 年每增加一个质量调整生命年（QALY）的成本（以美元计）表示。在 18-64 岁的成年人中，流感疫苗接种的 CE 范围为每 QALY8000 至 39000 美元。对于 65 岁及以上的成年人，CE 比率较低，从节省成本到每 QALY15300 美元不等。在中度或重度流感季节，对孕妇进行流感疫苗接种可节省每 QALY85000 美元的成本，在低发季节可节省每 QALY260000 美元的成本。对于其他预防干预措施，CE 估计值从节省成本到每 QALY 节省 50-74 岁女性乳腺癌筛查 170000 美元，从节省成本到每 QALY 节省 16000 美元用于结直肠癌筛查，以及从每 QALY27000 美元到 600000 美元用于高血压筛查和治疗不等。成人接种流感疫苗的 CE 情况似乎与成人常用的其他预防服务相似。鉴于流感疫苗接种带来的健康和经济效益，应考虑由成人患者提供者、医疗保健系统和支付方来推动成人接种疫苗。
