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    Kosteneffectiviteits-analyse van vaccinatie tegen influenza in Nederland

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    Authors
    Reinders A
    Postma MJ
    Sprenger MJW
    Series/Report no.
    RIVM Rapport 431501007
    Type
    Report
    Language
    nl
    
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    Title
    Kosteneffectiviteits-analyse van vaccinatie tegen influenza in Nederland
    Translated Title
    Analysis of the cost effectiveness of vaccination against influenza in the Netherlands
    Publiekssamenvatting
    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.
    In Nederland is een discussie gaande over de vraag of de regering influenzavaccinatie alleen zou moeten stimuleren bij risicogroepen of voor alle 65+'ers. Om de kosteneffectiviteit van beide vaccinatiestrategieen door te rekenen is een mathematisch model ontwikkeld. Dit model berekent de epidemiologische effecten alsmede de directe zorgkosten van een influenza-epidemie. Door alle 65+'ers te vaccineren daalt de incidentie van influenza, influenza gerelateerde sterfte en het aantal verloren levensjaren. Influenza gerelateerde zorg (huisartscontacten en verpleegdagen) en kosten dalen meer bij het vaccineren van 65+'ers dan bij het vaccineren van uitsluitend risicogroepen. Hoewel de zorgkosten dalen naarmate er meer mensen worden gevaccineerd, stijgen de kosten van vaccinatie sneller en daarmee de totale kosten. Indien de prijs van vaccinatie (vaccin en toediening) wordt verlaagd, dan zullen de kosten van vaccinatie eveneens dalen. Een break-even punt tussen stijgende vaccinatiekosten en dalende zorgkosten wordt bereikt indien de prijs van vaccinatie meer dan gehalveerd wordt. Vergeleken met een aantal andere preventieprogramma's is vaccineren tegen influenza relatief goedkoop. Zelfs met de huidige vaccinatieprijs kost een geimplementeerd programma als cervixkankerscreening meer dan anderhalf keer zoveel per gewonnen levensjaar. Het model is in de huidige vorm gebruikt voor besluitvorming binnen de regering. Omdat de ziekenhuiskosten een belangrijke component uitmaken van de zorgkosten, wordt nader onderzoek uitgevoerd om meer inzicht in de ziekenhuiskosten te krijgen.
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    URI
    http://hdl.handle.net/10029/10029
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