Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic
Authored by Bruce Y Lee, Sarah M Bartsch, Michael S Taitel, Jay V DePasse, Sarah N Cox, Renae L Smith-Ray, Patrick Wedlock, Tanya G Singh, Susan Carr, Sheryl S Siegmund
Date Published: 2018
DOI: 10.1016/j.vaccine.2018.09.040
Sponsors:
United States National Institutes of Health (NIH)
Platforms:
No platforms listed
Model Documentation:
Other Narrative
Model Code URLs:
Model code not found
Abstract
Introduction: During an influenza epidemic, where early vaccination is
crucial, pharmacies may be a resource to increase vaccine distribution
reach and capacity.
Methods: We utilized an agent-based model of the US and a clinical and
economics outcomes model to simulate the impact of different influenza
epidemics and the impact of utilizing pharmacies in addition to
traditional (hospitals, clinic physician offices, and urgent care
centers) locations for vaccination for the year 2017.
Results: For an epidemic with a reproductive rate (R0) of 1.30, adding
pharmacies with typical business hours averted 11.9 million symptomatic
influenza cases, 23,577 to 94,307 deaths, \$1.0 billion in direct
(vaccine administration and healthcare) costs, \$4.2-44.4 billion in
productivity losses, and \$5.2-45.3 billion in overall costs (varying
with mortality rate). Increasing the epidemic severity (R0 of 1.63),
averted 16.0 million symptomatic influenza cases, 35,407 to 141,625
deaths, \$1.9 billion in direct costs, \$6.0-65.5 billion in
productivity losses, and \$7.8-67.3 billion in overall costs (varying
with mortality rate). Extending pharmacy hours averted up to 16.5
million symptomatic influenza cases, 145,278 deaths, \$1.9 billion
direct costs, \$4.1 billion in productivity loss, and \$69.5 billion in
overall costs. Adding pharmacies resulted in a cost-benefit of \$4.1 to
\$11.5 billion, varying epidemic severity, mortality rate, pharmacy
hours, location vaccination rate, and delay in the availability of the
vaccine.
Conclusions: Administering vaccines through pharmacies in addition to
traditional locations in the event of an epidemic can increase
vaccination coverage, mitigating up to 23.7 million symptomatic
influenza cases, providing cost-savings up to \$2.8 billion to
third-party payers and \$99.8 billion to society. Pharmacies should be
considered as points of dispensing epidemic vaccines in addition to
traditional settings as soon as vaccines become available. (C) 2018 The
Author(s). Published by Elsevier Ltd.
Tags
Simulation
cost-effectiveness
Influenza
Epidemic
Vaccination
Pandemic influenza
Strategies
Seasonal influenza
United-states
Public-health
Disease burden
Pharmacies
Economic
Community pharmacy
A
h1n1