PharmacoEconomics & Outcomes News 647 - 18 Feb 2012

Postpartum influenza vax costbeneficial for society

Postpartum in-hospital influenza vaccination is costbeneficial for society in the US, say researchers of aCDC*-supported study published in Obstetrics &Gynecology.1

The researchers developed a decision analysis modelfor a hypothetical cohort of 1.47 million postpartumwomen and estimated the potential cost benefit** ofvaccination versus no vaccination. The model used atime horizon of 1 year and costs were reported in 2010values. It was assumed that women were vaccinatedwith a trivalent injectable inactivated vaccine.

From the societal perspective, the expected costs permother were $US328 and $341 in the vaccinated andunvaccinated cohorts, respectively, which resulted in anexpected net benefit of $12.57. For the entire cohort, theoverall cost savings were predicted to be $3.39–$14.75million, depending on the vaccination coverage rate. Theresearchers say that the vaccination strategy was costbeneficial, holding all other variables to the base case,when the vaccine efficacy was more then 47%, theannual maternal influenza attack rate was more then2.8% and the vaccine administration and acquisitioncosts per dose were less than $32.78. However, theyadd that vaccination would not result in cost savingsfrom the third-party payer perspective.

Alert increases uptake in pregnant womenMeanwhile, results of a second study published in

Obstetrics & Gynecology, suggest that a best-practicealert added to electronic records increases influenzavaccine rates in pregnant women.2

This study compared the rates of vaccination anddocumented discussions on influenza in pregnantwomen before (2007–2008) versus after implementingthe alert (2008–2009). The best-practice alert let thehealthcare provider know at at each prenatal visitwhether the patient had been vaccinated or had voicedinformed refusal.

In 2008–2009, influenza vaccine rates significantlyexceed those in 2007–2008 (61% vs 42%; p < 0.001).Furthermore, there was a significantly higher rate ofdocumented discussions about influenza with thepregnant women (90% vs 50%; p < 0.001). In2008–2009, the most common reason for not receivingthe vaccine was informed refusal, whereas in2007–2008 the majority of medical records ofunvaccinated women showed no documenteddiscussions. In contrast, the majority (68%) of womenwho had a documented discussion with their healthcareprovider in 2008–2009 went on to receive the vaccine.* Centers for Disease Control and Prevention** from a societal (base-case analysis) and third-party payerperspectives

1. Ding Y, et al. Cost-benefit analysis of in-hospital influenza vaccination ofpostpartum women. Obstetrics and Gynecology 119: 306-14, No. 2, Part 1, Feb2012. Available from: URL: http://dx.doi.org/10.1097/aog.0b013e318242af27.

2. Klatt TE, et al. Effect of a best-practice alert on the rate of influenza vaccinationof pregnant women. Obstetrics and Gynecology 119: 301-5, No. 2, Part 1, Feb2012. Available from: URL: http://dx.doi.org/10.1097/aog.0b013e318242032a.

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PharmacoEconomics & Outcomes News 18 Feb 2012 No. 6471173-5503/10/0647-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved