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Cost Effectiveness of the 4 Pillars™ Practice Transformation Program to Improve Vaccination of Adults Aged ≥65 years
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Dec 26 2016
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Source: J Am Geriatr Soc. 65(4):763-768.
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Alternative Title:J Am Geriatr Soc
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Description:Objectives
Interventions to improve adult vaccination uptake in primary care have met with limited success, raising questions about whether the benefits to patients are worth the time and resources necessary to implement them. Here we examine the cost effectiveness of an intervention to increase pneumococcal, influenza and pertussis-containing vaccine uptake among adults ≥65 years of age in primary care practices.
Design
Markov decision analysis model, estimating the cost-effectiveness of the 4 Pillars™ Practice Transformation Program compared with no intervention.
Setting
Diverse primary care practices in 2 US cities
Participants
Clinical trial patients aged 65 years and older. Vaccination rates and intervention costs were derived from a randomized controlled cluster trial. Other parameters were derived from the medical literature and CDC data. All parameters were individually and simultaneously varied over their distributions.
Measurements
Quality adjusted life years (QALYs), public health outcomes, and costs
Results
With the intervention program and extrapolating over 10 years, there would be ~60,920 fewer influenza cases, 2,031 fewer pertussis cases, and 13,842 fewer pneumococcal illnesses among adults ≥65 years. Compared to no intervention, total per-person vaccination and illness costs with the intervention were $1.60 higher with a concurrent increase in effectiveness of 0.0031 QALYs, or $512 per QALY gained. In sensitivity analyses, no individual parameter variation caused the intervention to cost >$20,000 per QALY gained.
Conclusions
Implementing an intervention based on the 4 Pillars™ Practice Transformation Program is a cost-effective undertaking in primary care practices for patients ≥65 years old with predicted public health benefits.
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Pubmed ID:28024090
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Pubmed Central ID:PMC5397321
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