OBJECTIVES

To compare the economic impact on direct medical costs of the use of high dose (HD) versus standard dose (SD) influenza vaccination in adults 65 years of age or older enrolled in the United States (US) Veteran’s Health Administration (VHA), we estimated the effect both vaccines had on hospitalization costs for cardio-respiratory disease.

METHODS

Leveraging a relative vaccine effectiveness study of HD versus SD over five influenza seasons (2010/11 through 2014/15) in the VHA, we collected cost data for healthcare provided to these subjects at VHA, as well as through Medicare services. Our economic assessment compared the costs of vaccination and hospital care for patients experiencing cardio-vascular or respiratory illness.

RESULTS

We analyzed 3.5 million SD and 158,636 HD person-seasons. The average cost of HD and SD vaccination were $23.48 (95% CI: $21.29 - $25.85) and $12.21 (95% CI: $11.49 - $13.00) per recipient, respectively. In contrast, the hospitalization rates for cardio-respiratory disease in HD and SD recipients were 0.114 (95% CI: 0.108 - 0.121) and 0.132 (95% CI: 0.132 - 0.133) per person-season, respectively. Attributing the average cost per hospitalization of $11,796 (95% CI: $11,685 - $11,907) to the difference in hospitalization rates, HD saved the US taxpayer $202 (95% CI: $115 – $280) per recipient.

CONCLUSIONS

For the five-season period of 2010/11 through 2014/15, HD influenza vaccination was associated with net cost savings due to the prevention of hospitalizations for cardio-respiratory disease as compared to SD influenza vaccination in the US VHA population.