Managed Care - October 2008 - (Page IS8) FACULTY PRESENTATION Societal and Economic Consequences Of Influenza PEDRO A. PIEDRA, MD Baylor College of Medicine, Houston SUMMARY also are priority populations for influenza immunization. It is now clear, however, that this risk-based approach has not been successful in reducing overall morbidity and mortality from the disease, and the medical community is beginning to consider new strategies for influenza prevention. Influenza is a major medical and economic burden in the United States. According to a systematic evaluation of influenza outcomes from 2001 to 2003, about 31 million outpatient visits each year are related to flu sympInfluenza is a disease with a significant impact on pubtoms, accounting for about 3.1 million hospitalized days lic health, affecting between 5 and 20 percent of the U.S. (Molinari 2007). Influenza is the number one vaccinepopulation each year. It occurs with substantially greater preventable cause of death among both adults and chilfrequency and significantly more mortality than dren, leading to an estimated 610,660 life-years is observed with any other vaccine-preventable lost (Molinari 2007). disease. For example, in comparison with pneuDirect medical costs due to influenza, admococcal disease (40,000 cases and 5,500 justed to 2003 prices, average $10.4 billion, and deaths), human papillomavirus (10,532 cases projected lost earnings as a result of illness and and 3,900 deaths), hepatitis B (6,741 cases and loss of life account for $16.3 billion (Molinari 685 deaths), and varicella (20,948 cases and 16 2007). The total annual economic burden from deaths), there are about 31 million cases of ininfluenza across all age groups (using projected fluenza in the United States, leading to approxstatistical life values) is $87.1 billion. When asimately 36,000 excess deaths annually (Thompsociated with health outcome, 83 percent of son 2003, Weycker 2005, CDC 2008, ACS 2004). the total cost of influenza is attributable to PEDRO A. Furthermore, this disproportionate incidence of death, 7 percent to hospitalizations, and 8 perPIEDRA, MD influenza occurs in a relatively short time period cent to outpatient care. These results empha— generally about 10 to 12 weeks — that reflects the seasize that the impact of influenza in the United States resonal profile of the epidemic. mains high, with an exorbitant cost related to lost productivity and disease-related death rather than from Traditionally, the approach to vaccine control of inhospitalization. In addition, the loss of productivity and fluenza has been based on covering high-risk populathe time away from work hinders national economic tions. Until recently, vaccination efforts primarily have growth. Thus, more focused and effective prevention focused on individuals 50 years of age or older, residents of chronic care facilities, children and adults with chronic strategies would not only improve quality of life for inconditions that place them at high risk for influenza dividual Americans affected by influenza, but also would positively affect the country’s economy. complications, and, more recently, children younger than 5 years of age. Pregnant women and health care workers High rates of vaccination coverage for preschool and school-aged children can reduce morbidity and mortality related to influenza outbreak. More focused and effective influenza prevention strategies are necessary to improve quality of life and to limit the burden of flu complications. Disease burden Changing recommendations for vaccination Pedro A. Piedra, MD, is a professor in the Department of Molecular Virology, Microbiology, and Pediatrics, Baylor College of Medicine. The failure of a risk-based vaccination strategy to improve morbidity and mortality from influenza has in recent years led a number of monitoring agencies to recon- 8 MANAGED CARE / SUPPLEMENT
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