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Cost-effectiveness of a comprehensive immunization program serving high-risk, uninsured adults
Kimberly J Wilson1, H Shelton Brown1, Ujas Patel1
1University of Texas Health Science Center School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, United States of America.
Preventive Medicine
|November 4, 2019
Summary
Adult immunization programs are cost-effective, even for high-need populations. Investing in community-delivered vaccination saves lives and is a worthwhile public health endeavor.
Area of Science:
- Public Health
- Health Economics
- Vaccinology
Background:
- Adult immunization rates are low in the US, leading to significant healthcare costs and lost productivity.
- Childhood immunization is known to be cost-effective, but the economic impact of adult programs varies.
- High-need populations often have lower vaccination rates, exacerbating health disparities.
Purpose of the Study:
- To evaluate the cost-effectiveness of a comprehensive adult immunization program delivered by a local health department (LHD) in partnership with community organizations.
- To assess the economic value of adult vaccination programs targeting uninsured, low-income, and high-risk individuals.
- To determine the incremental cost-effectiveness ratio (ICER) for a community-based adult immunization initiative.
Main Methods:
- Modeled incremental cost-effectiveness from a payer perspective for individual vaccines and the overall program.
- Used simulated cohorts of 100,000 individuals over a 20-year horizon.
- Incorporated data from the LHD and published literature, adjusting for actual program delivery and using a 3% discount rate for benefits and life years saved (LYS).
Main Results:
- Four out of seven disease-specific models met the cost-effectiveness threshold of $100,000/LYS, with ICERs ranging from $14,260 to $79,022/LYS.
- Sensitivity analyses confirmed the robustness of the base model results.
- The overall program ICER was $67,940/LYS, indicating significant value.
Conclusions:
- A community-delivered, comprehensive adult immunization program serving high-need populations is a cost-effective investment.
- The program demonstrates value even when participants do not receive the full recommended vaccine regimen.
- Investing in such programs can improve population health outcomes and reduce long-term healthcare expenditures.
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