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Ontario’s Universal Flu Vaccination Plan

April 7, 2010

The millions of dollars invested by the province of Ontario in its universal flu vaccine campaign saves lives and is a sensible investment, according to an economic analysis by a researcher at the University of Toronto and the University Health Network.

Even though the estimated $40 million annual cost of Ontario’s flu vaccine campaign is double the price tag of a vaccination campaign targeted to specific populations, the universal campaign remains “economically attractive,” said Beate Sander, a doctoral student at the University of Toronto Faculty of Medicine’s Department of Health Policy, Management & Evaluation and a researcher at the University Health Network’s Division of Clinical Decision-Making and Health Care Research.

“Compared to a targeted influenza immunization program, the universal program reduces influenza illness attack rates, morbidity and mortality at reasonable cost to the taxpayer,” said Sander, also of the Toronto Health Economics and Technology Assessment Collaborative. The study by Sanders and her colleagues was published today in the journal PloS Medicine.

Each year, outbreaks of influenza cause an estimated 500,000 deaths worldwide and generate heavy health care costs. To mitigate that impact, some jurisdictions have implemented immunization programs targeted to vulnerable populations. Ontario’s vaccine campaign, launched in 2000, is universal, making the vaccine freely available to all. Sander’s study compared Ontario’s universal program ($40 million, including cost of vaccine, promotion and physician compensation) vs. the estimated cost and effectiveness of a theoretical targeted program for Ontario ($20 million) during the same timeframe.

“Aside from saving lives and sparing people from suffering the flu, preventing influenza cases effectively reduced influenza-related health care costs by 52% and saved the health care system $7.8 million per season,” Sander said.

Among the findings of Sander and her colleagues:

* Estimated number of influenza cases prevented each season: 34,541 (61% of all cases each season)
* Estimated number of influenza deaths prevented each season: 111 (28% reduction in mortality)
* Estimated number of influenza-related hospitalizations prevented each season: 786 (46% reduction)
* Estimated number of Emergency Department visits prevented each season: 7,745 (61% reduction)
* Estimated number of doctor office visits prevented each season: 30,306 (61% reduction)

A healthier population means lowered health care costs. Sander estimated that 39% of the costs of the universal immunization campaign were offset by savings ““ fewer doctor visits, fewer Emergency Department visits and fewer hospitalizations.

“Policy makers in other jurisdictions have been looking at Ontario’s program as they consider implementing their own universal influenza immunization program. Our economic evaluation suggests the relationship between costs and health benefits make it economically attractive,” Sander said.

Other collaborators in this research:

Jeffrey C. Kwong (Institute for Clinical Evaluative Sciences; Department of Family and Community Medicine, Dalla Lana School of Public Health ““ University of Toronto Faculty of Medicine)

Chris T. Bauch (Toronto Health Economics and Technology Assessment Collaborative; Department of Mathematics and Statistics, University of Guelph)

Andreas Maetzel (Department of Health Policy, Management & Evaluation ““ University of Toronto Faculty of Medicine; Amgen [Europe] GmbH, Zug, Switzerland)

Allison McGeer (Division of Infectious Diseases, University Health Network; Department of Laboratory Medicine & Pathobiology ““ University of Toronto Faculty of Medicine)

Janet M. Raboud (Dalla Lana School of Public Health ““ University of Toronto Faculty of Medicine; Division of Infectious Diseases, University Health Network)

Murray Krahn (Department of Health Policy, Management & Evaluation ““ University of Toronto Faculty of Medicine; Division of Clinical Decision-Making and Health Care Research, University Health Network; Toronto Health Economics and Technology Assessment Collaborative; Faculty of Pharmacy and Department of Medicine, Faculty of Medicine — University of Toronto)

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