Welcome to CDC stacks | Cost Effectiveness of the 4 Pillars™ Practice Transformation Program to Improve Vaccination of Adults Aged ≥65 years - 45414 | CDC Public Access
Stacks Logo
Advanced Search
Select up to three search categories and corresponding keywords using the fields to the right. Refer to the Help section for more detailed instructions.
Clear All Simple Search
Advanced Search
Cost Effectiveness of the 4 Pillars™ Practice Transformation Program to Improve Vaccination of Adults Aged ≥65 years
  • Published Date:
    Dec 26 2016
  • Source:
    J Am Geriatr Soc. 65(4):763-768.

Public Access Version Available on: April 01, 2018 information icon
Please check back on the date listed above.
  • Pubmed ID:
  • Pubmed Central ID:
  • Description:

    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.


    Markov decision analysis model, estimating the cost-effectiveness of the 4 Pillars™ Practice Transformation Program compared with no intervention.


    Diverse primary care practices in 2 US cities


    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.


    Quality adjusted life years (QALYs), public health outcomes, and costs


    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.


    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.

  • Document Type:
  • Collection(s):
  • Funding:
    R01 AI116575/AI/NIAID NIH HHS/United States
    U01 IP000662/IP/NCIRD CDC HHS/United States
    UL1 RR024153/RR/NCRR NIH HHS/United States
    UL1 TR000005/TR/NCATS NIH HHS/United States
  • Supporting Files:
    No Additional Files
No Related Documents.
You May Also Like: