Abstract
6079 Background: Despite recommendations to immunize all patients at increased risk from underlying immunosuppressive disease against influenza, many insurance plans do not cover the vaccine. We analyzed the cost-effectiveness of vaccinating adult cancer patients against influenza from the perspective of a third-party payer. Methods: We developed a decision-analytic model using epidemiological, vaccine effectiveness, resource utilization, cost, and utility data from published sources, supplemented with data collected from our institutional accounting system. Two strategies were compared: vaccination of adult cancer patients against influenza, and no vaccination. The cost-effectiveness analysis included charges (inflated to 2005 US$) for vaccination, influenza-related hospitalizations, physician and emergency visits, and the average wholesale price for prescription drugs and influenza vaccine. The base-case patient for the model was assumed to be a 67-year-old cancer patient (the median age at initial cancer diagnosis - all sites - for the 1998–2002 SEER population) with active disease. Results: The effectiveness of the no vaccination strategy was 4.665 QALYs at a cost of $95.23. The effectiveness of the influenza vaccine was 4.672 QALYs at a cost of $70.73. Thus, the vaccination strategy provided an incremental effectiveness of 0.007 QALYs over the no vaccination strategy at a reduction in cost of $24.50. Based on these gains, we estimate that vaccination of all adult cancer patients could potentially save third-party payers over $87 million in addition to gains in clinical benefits. The model was not sensitive to plausible changes in cancer survival, incidence of influenza, vaccine effectiveness, vaccine price, and risk of influenza-related hospitalization. Conclusions: Influenza vaccine is cost-effective for adult cancer patients. Health plans should expand their coverage to include the vaccine for adult patients with cancer. No significant financial relationships to disclose.
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