OBJECTIVES : Individuals aged 65 years and older constitute an important risk group for influenza infection and related complications. As a national policy, influenza vaccine is supplied free for this risk group, however, vaccination rates are quite low. We aimed to demonstrate the spendings of inpatients who are infected with influenza and to investigate the effectiveness and cost saving of vaccination for Turkey.

METHODS : Patients hospitalized in internal medicine wards and who had nasal swab sampling for a suspected viral infection were included between 1 August 2018 to 31 March 2019. Patients were followed until discharge or exitus. Hospital spendings were retrieved from the Hospital Information Management System.

RESULTS : Data of 26 influenza positive patients over 65 years of age was analyzed. The mean total hospital spending of those inpatients was 9,168 TRY per patient. The spendings were 10,579 TRY for unvaccinated inpatients, while 4,463 TRY for vaccinated patients. The number of people over 65 years of age is 7,186 204 with regards to 2018 TURKSTAT. The influenza related hospitalization prevalence was retrieved from the European study of Preaud et al. Poland was selected as the reference country, which has a similar flu vaccination coverage rate and the prevalence was 189 influenza-related hospitalizations per 100,000. The calculations yielded that the total cost of hospitalization for unvaccinated elderly was 143,687,361 TRY, while it was 60, 621,062 TRY for the vaccinated elderly. For pharmaceutical expenditure these correspond to 38,274,076 TRY for unvaccinated and 15,116,776 TRY for the vaccinated ones.

CONCLUSIONS : We demonstrated that by vaccinating elderly people, 58% of total spending and 61% of pharmaceutical expenditure can be prevented considering even that vaccinated elderly people also got flu positive and hospitalized. With effective vaccines and higher coverage rates, these cost savings might be much more remarkable.