Cost-benefit analysis of vaccination against four preventable diseases in older adults: Impact of an aging population

• Published in: Vaccine Vol. 39; no. 36; pp. 5187 - 5197
• Main Authors: Carrico, Justin, Talbird, Sandra E., La, Elizabeth M., Poston, Sara, Poirrier, Jean-Etienne, DeMartino, Jessica K., Hogea, Cosmina
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 23.08.2021; Elsevier Limited
• Subjects: Adult vaccines; Adults; Age; Aging; Aging population; Cost benefit analysis; Cost control; Coverage; Decision trees; Discount rates; Disease; Economic analysis; Economic model; Economic models; Economics; Health care expenditures; Herd immunity; Herpes zoster; Impact analysis; Infectious disease; Influenza; Kindergarten students; Net present value; Older people; Parameter sensitivity; Pertussis; Population; Population studies; Public health; Sensitivity analysis; Vaccination; Vaccine efficacy; Vaccines; Whooping cough; United States > US; Cost-benefit analysis; Infectious disease; Aging population; Economic model; Adult vaccines
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2021.07.029

•US adult vaccination is projected to prevent 65 million disease cases over 30 years.•The averted societal costs of cases would outweigh vaccination costs by about $49 billion.•With an increase in vaccination coverage, 33 million more disease cases could be avoided.•The coverage increase would result in $13 billion additional societal cost savings. This exploratory study estimates the economic value of the current vaccination program and increased coverage against four preventable diseases in older adults in the United States (US). A population-based, age-structured economic model was used to conduct a cost-benefit analysis of vaccination against influenza, pertussis, herpes zoster, and pneumococcal disease among US adults aged 50 years and older, accounting for aging of the population. The model used separate decision trees for each disease to project the discounted number of vaccinated individuals, number of disease cases, and direct medical and indirect costs (2018 US$) over a 30-year period. Benefit-cost ratios (BCRs) and net present values were calculated for two primary analyses comparing current vaccination coverage versus no vaccination and comparing increased coverage versus current coverage. Key parameter values were varied in deterministic sensitivity analyses. Current adult vaccination coverage (vs. no vaccination) is estimated to result in nearly 65 million averted disease cases, $185 billion averted costs of cases, and $136 billion in incremental vaccination costs over a 30-year period from a societal perspective (BCR = 1.4). Increased vaccination coverage (vs. current coverage) is associated with over 33 million additional averted disease cases, $96 billion additional averted costs of cases, and nearly $83 billion in incremental vaccination costs, resulting in a societal BCR of 1.2 over 30 years. Deterministic sensitivity analyses demonstrated that results were most sensitive to disease incidence, vaccine efficacy, and productivity costs for time required for vaccination. Study results highlight the economic value of vaccination programs for older adults in the US and indicate that efforts to further increase vaccination coverage may be warranted and economically justifiable.