The cost of heath care for vaccine preventable diseases

A recent study stated that total cost to the U.S. health care system for vaccine treatable diseases was estimated to be almost 9 billion dollars,  just for 2015 alone. The study also estimated that over 7 billion dollars of that cost was due to people who didn’t get vaccinated, or almost 80% of that total. 80%….

Let’s first of all understand the who, what, and why  of this study.

The who: the study comes from a very reputable source, the UNC Eshelman School of Pharmacy. Since I (and others) believe that this is the best pharmacy school in the nations, I trust their findings. However, I also want to point out that the WHY of this study was that it was funded by Merck, a company who has a finger in the jar, so to speak, of  vaccine revenues. It is Merck’s interest to try to get more people to be vaccinated.

And finally the what of this study: estimating the cost of health care (care, medication and lost productivity) for the unvaccinated. The term vaccine preventable diseases is fairly self explanatory. However, let’s break down the findings farther. The study indicates influenza was responsible for the biggest chunk of the overal expense for vaccine preventable diseases, with about 5.2 billion going to treating patients who have come down with the flu. But let’s investigate the vaccine used to prevent flu. From the CDC:

The updated VE estimate against influenza A H3N2 viruses was 18% (95% confidence interval (CI): 6%-29%).This result is similar to the VE point estimate of 23%, which was reported in a January 16 and confirms reduced protection against H3N2 viruses this season. The VE estimate against influenza B viruses this season was 45% (95% CI: 14% – 65%).

A 45% effectiveness rate is considered good, but 18-23% effectiveness is not. Therefore the cost of treating the flu last year, was not only due to people who were not vaccinated, but also that the vaccine itself was not as capable of preventing infection.

The lack of effectiveness of the flu vaccine wasn’t necessarily due to a bad vaccine, but that but that circulating flu virus had mutated antigenically.  The CDC tested the viruses causing disease and determined that anywhere from 65 to 85% of  all H3N2 viruses tested had drifted antigenically from the vaccine strain used.

And finally, the study did not deduct the cost of the vaccines in the amount of money they estimated. One report indicated that the cost of vaccinating everyone for the flu (with the cheapest vaccine of $14) would have cost roughly 3.57 billion. The cost of Merck’s Gardasil vaccine?  $120 for each shot. So should factoring the cost of the vaccines have been included in the overall monetary numbers indicated?

 

But lastly in Merck’s defense, it has just been published that the Gardasil vaccine is so effect, they are reducing the number of doses needed from three to two (with a final cost of $240 for the two dose series), but also that the vaccine has been amazing good at prevention of actual disease of genital warts but more importantly, human cervical cancer.

About Dr. Cramer

Dr. Lorraine Cramer teaches undergraduate Microbiology and Immunology to students at the University of North Carolina in Chapel Hill.
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