Abstract

In the Netherlands there is an ongoing discussion about the question whether the government should stimulate vaccinating only risk groups or all persons of 65 years and older against influenza. To evaluate the cost-effectiveness of both vaccination strategies a mathematical model has been developed. The model computes the epidemiological effects as well as the direct costs of care of an influenza epidemic. Vaccinating the elderly decreases the number of cases of influenza, mortality due to influenza and influenza related diseases and the number of years of life lost. Influenza related care (the number of GP-contacts and hospital days) and costs decrease more with the 65+ scenario compared to the risk group scenario. Although the cost of care decreases when vaccinating more persons, the cost of vaccination increases more and thus the total costs. If the price of vaccination (vaccine and administering) is decreased, the cost of vaccination will decrease as well. A break-even point between rising vaccination costs and decreasing care costs will be reached when the price of vaccination is more than halved. Compared to a number of other programmes vaccination against influenza is relatively cheap. Even with the current price of vaccination, an implemented programme for screening cervix cancer costs more than one and half as much per year of life gained. The model in its current form has been used for decision making by the government. Because the cost of hospitalization is a major component of the costs of care, further study is being executed to get more insight in the costs of hospitalization.