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Estimated Reductions in Influenza-related Mortality among the Elderly through

Estimated Reductions in Influenza-related Mortality among the Elderly through Direct-to-Consumer Advertising of Influenza Vaccine Mitesh S Patel* Matthew M. Davis # *University of Michigan Medical School, and

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Estimated Reductions in Influenza-related Mortality among the Elderly through

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  1. Estimated Reductions in Influenza-related Mortality among the Elderly through Direct-to-Consumer Advertising of Influenza Vaccine Mitesh S Patel* Matthew M. Davis# *University of Michigan Medical School, and #Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, Division of General Internal Medicine, and Gerald R. Ford School of Public Policy, University of Michigan

  2. Influenza Mortality • Predominately and disproportionately impacts elderly • Rates of annual influenza vaccination among the elderly are approximately 65% • Vaccination rates fall short of the Healthy People 2010 target of 90% and may be a concern on the national level

  3. Direct-to Consumer (DTC) Advertising • Spending on DTC advertising rose from $266 million in 1994 to $3.2 billion in 2003 • Effective method of increasing sales of prescription pharmaceuticals • Could it be an effective method of increasing influenza vaccination rates and achieving mortality benefits?

  4. Research Objective • To examine the potential cost-effectiveness of a federal program of DTC advertising for influenza vaccination of elders

  5. Methods: Number Needed to Vaccinate • Number Needed to Vaccinate (NNV) • Quantifies the number of people that must be vaccinated to prevent one all-cause death • Analogous to the Number Needed to Treat (NNT) • NNV = 1 ___________________________________________________________________________________________________________________________ (population mortality rate) x (vaccine efficacy against mortality)

  6. Methods: DTC Advertising and Pharmaceutical Sales • DTC advertising in 1999 Findlay. Pharmacoeconomics. 2001.

  7. Methods: Vaccination Rate Increase . .

  8. Methods: Vaccination Rate Increase ?

  9. Methods: Vaccination Rate Increase

  10. Methods: Model Parameters

  11. Methods: Model Parameters

  12. Methods: Model Parameters

  13. Methods: Model Parameters

  14. Methods: Model Parameters

  15. Methods: Model Parameters

  16. Methods: Model Parameters

  17. Methods: Primary Outcome Measures • For each year 2006-2015 we estimated • Reduction in mortality • Cost per life-year saved = ∑Year = x[cost (DTC + Vaccination)] - ∑Year = (x-1)[cost (DTC + Vaccination)] Year=2006Year=2006 __________________________________________________ ∑Year = x[life-years saved] - ∑Year = (x-1)[life-years saved] Year=2006 Year=2006

  18. Results: Base Case – First Year of Program

  19. Results: Base Case – First Year of Program

  20. Results: Elderly Lives Saved

  21. Results: Cost-Effectiveness of a 10-year DTC Program for Influenza Vaccine

  22. Results: Cost-Effectiveness of a 10-year DTC Program for Influenza Vaccine

  23. Results: Cost-Effectiveness of a 10-year DTC Program for Influenza Vaccine

  24. Results: Overall Cost-Effectiveness

  25. Study Limitations • Mortality benefits of influenza vaccination • DTC advertising has only been studied for boosting pharmaceutical sales • Medicare incurs greater program costs • Annual cost per average beneficiary is $5,400 • Average life expectancy of elders in hypothetical cohort is 11.7 years

  26. Summary • Overall the cost per life-year saved is about $27,000 for the 10-year DTC promotion of influenza vaccine for the elderly • Sensitivity analysis • Worst case • Cost per life-year saved < $40,000 • Total lives saved > 7,000 lives • Total cost of DTC advertising over 10 years = $2.2 billion

  27. Implications • First study to suggest potential benefits of DTC advertising on public immunization efforts • DTC advertising directed towards elders may • Induce demand for influenza vaccine • Raise vaccination rates towards the target of 90% • Achieve mortality benefits • Be cost-effective for the Federal Government to pursue

  28. Estimated Reductions in Influenza-related Mortality among the Elderly through Direct-to-Consumer Advertising of Influenza Vaccine Mitesh S Patel* Matthew M. Davis# *University of Michigan Medical School, and #Child Health Evaluation and Research (CHEAR) Unit, Division of General Pediatrics, Division of General Internal Medicine, and Gerald R. Ford School of Public Policy, University of Michigan

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