Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic. Issue 46 (12th November 2018)

• Record Type: Journal Article
• Authors: Bartsch, Sarah M.; Taitel, Michael S.; DePasse, Jay V.; Cox, Sarah N.; Smith-Ray, Renae L.; Wedlock, Patrick; Singh, Tanya G.; Carr, Susan; Siegmund, Sheryl S.; Lee, Bruce Y.
• Is Part Of: Vaccine. Volume 36:Issue 46(2018)
• Page Start: 7054
• Page End: 7063
• Publication Date: 2018-11-12
• Subjects: Influenza -- Epidemic -- Pharmacies -- Vaccination -- Economic; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2018.09.040
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Pharmacies may help increase vaccine distribution reach and capacity for an epidemic. Adding pharmacies averted 11.9–16.0 million influenza cases and 23, 577–210, 228 deaths. Thus saving $1.0–2.8 billion in direct costs and $4.1–99.8 billion in overall costs. Pharmacies should be considered as points of dispensing epidemic vaccines. 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.