Economic evaluations of influenza vaccination in the elderly - Impact on public health policy

Objective: To determine (i) whether influenza vaccination in the elderly is cost effective or cost saving compared with a non-intervention strategy an d (ii) whether it is worth framing a vaccination policy for this population . Background: Influenza causes substantial morbidity and mortality in elderly people. Despite the availability of effective vaccines against this diseas e, vaccine coverage in the elderly is low in many countries. Evaluations of the economic impact of influenza vaccination can support public health pol icy decisions concerning vaccination and also may help influence changes in practice behaviour. Methods: We performed a literature review of cost-benefit and cost-effectiv eness evaluations of influenza vaccination in the elderly. We provide a sum mary of the principal findings from 11 economic evaluations of influenza im munisation and discuss their effect on policy decisions for vaccination in the elderly population. Results: The cost-benefit and cost-effectiveness results in elderly individ uals, derived from 7 model-based simulations, 3 observational analyses and a case-control study, all support the recommendations for vaccination of al l persons of 65 years and over that are currently endorsed in the US, Austr alia, New Zealand and many European countries. All evaluations showed that influenza immunisation was cost effective or would result in cost savings c ompared with a no-vaccination strategy. Conclusions: Although clinical and economic data indicate the benefit of in fluenza vaccination in the elderly the vaccine coverage rate in many countr ies is disappointing, even when vaccine is provided free of charge. It is c lear that strategies aimed at the patient or healthcare provider lire neede d to increase implementation of a vaccination policy to ensure that any rec ommended vaccine programme is clinically and economically effective.