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. 2021 Aug 23;39(36):5187-5197.
doi: 10.1016/j.vaccine.2021.07.029. Epub 2021 Jul 30.

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

Justin Carrico  1 , Sandra E Talbird  2 , Elizabeth M La  3 , Sara Poston  4 , Jean-Etienne Poirrier  5 , Jessica K DeMartino  5 , Cosmina Hogea  6
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Free article

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

Justin Carrico et al. Vaccine. .
Free article

Abstract

Objective: 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).

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Adult vaccines; Aging population; Cost-benefit analysis; Economic model; Infectious disease.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sandra E Talbird and Justin Carrico declare they are employed by RTI Health Solutions, which received funding from the GSK group of companies to conduct this study. Elizabeth M La, Sara Poston and Cosmina S Hogea declare they are employed by the GSK group of companies and hold shares in the GSK group of companies. Jean-Etienne Poirrier and Jessica K DeMartino declares that they were employed by the GSK group of companies and held shares in the GSK group of companies at the time of the study. The authors declare no other financial and non-financial relationships and activities.

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