In flu epidemic, vaccinating at pharmacies could save $100 billion
In the event of an influenza epidemic caused by a novel virus, vaccinating people at pharmacies in addition to traditional locations has the potential to alleviate up to 23.7 million symptomatic cases, saving society $99.8 billion and third-party payers $2.8 billion, researchers found.
According to Bruce Y. Lee, MD, MBA, associate professor of international health and executive director of the Global Obesity Prevention Center (GOPC) at the Johns Hopkins Bloomberg School of Public Health, pharmacies have not been a focus of vaccine distribution plans in any influenza pandemic, including the last one in 2009.
“It’s only more recently where pharmacies have become more and more utilized as vaccination locations,” Lee told Infectious Disease News. “They are places where health care can be distributed. If you’re going to make plans on how to prevent an epidemic or how to respond to a pandemic, you may want to make sure you include pharmacies in the decision-making.”
Recently, officials reported that during the 2017-2018 influenza season, 80,000 people in the United States died and an estimated 900,000 were hospitalized. Public health officials emphasize the need for vaccination, especially among young children, adults older than 65 and women who are pregnant or planning to become pregnant.
According to Lee and colleagues, as of 2009, pharmacists in every state were trained to vaccinate people. Nearly 86% of the U.S. population lives within 5 miles of a pharmacy, but in 2017, only 28.2% of adults and 4.9% of children received the influenza vaccine from a pharmacy, they reported.
For their study, Lee and colleagues used modeling to simulate the potential impact of using pharmacies in addition to traditional vaccination locations such as hospitals, clinics, physician offices and urgent care centers, to dispense influenza vaccines during 2017. According to the study, they simulated the impact of different influenza epidemics in the United States. Societal costs were defined as direct and indirect costs, such as productivity losses due to absenteeism or mortality.
When Lee and colleagues looked at an epidemic with a reproductive rate of 1.30, 11.9 million symptomatic influenza cases and 23,577 to 94,307 deaths were averted when pharmacies with traditional business hours were added as influenza vaccine locations. Offering vaccinations at pharmacies saved $1 billion in direct costs, $4.2 billion to $44.4 billion in productivity losses and $5.2 billion to $45.3 billion in overall costs.
Lee and colleagues also assessed averted costs, influenza cases and death during an increased severity epidemic with a reproductive rate of 1.63. In this scenario, vaccinating at pharmacies averted 16 million symptomatic influenza cases and 35,407 to 141,625 deaths. Additionally, this saved $1.9 billion in direct costs, $6 billion to $65.5 billion in productivity losses and $7.8 billion to $67.3 billion in overall costs, according to the study.
Lee and colleagues also found that 16.5 million symptomatic influenza cases and 145,278 deaths could potentially be avoided by extending pharmacy hours. If this occurred, it could save $1.9 billion in direct costs, $4.1 billion in productivity losses and $69.5 billion in overall costs.
The researchers highlighted that adding pharmacies to influenza vaccination strategies may result in a cost-benefit of $4.1 billion to $11.5 billion. Adding pharmacies to traditional vaccination locations may also impact the epidemic severity, mortality rate and delay in the availability of the vaccine, according to the study.
“The other consideration is we have to think about geographic reach — in other words, reaching all kinds of populations,” Lee said. “It might address potential disparities or inequities to health access.” – by Marley Ghizzone
Disclosures: The authors report that the study was funded by Walgreens Pharmacy.