As summer edges to a close, the focus shifts once more to the winter flu season and vaccinations. However, while flu vaccinations have been shown to be a huge success, a recent white paper, An Economic Analysis of Flu Vaccination, considers the different uptake and efficacy scenarios of the English flu vaccination programme and explores the economic benefit of vaccinations.
David Sinclair, director of the International Longevity Centre – UK which produced the white paper, discusses the benefits of vaccinations to health and healthcare and considers how the vaccination programme might be delivered more efficiently.
Every winter primary care in the UK manages a great achievement – vaccinating millions of the population who are at particular risk from flu. A report by the think-tank I lead, the International Longevity Centre – UK, shows the success of the programme.
Reducing GP consultations and hospitalisations
We think vaccination averts between 180,000 and 626,000 cases of influenza per year in England, depending on the match of the vaccine to circulating viruses and the strength of the flu season. This is a huge number, and the associated reduction in GP consultations and hospitalisations is obviously beneficial both to the NHS and the country as a whole.
It’s also clear that there is a reduction in premature mortality due to vaccination against flu – in the order of between 5,678 and 8,800 deaths every flu season. The very young and the old generate the highest levels of costs, due to higher rates of hospitalisation; over 1,800 individuals aged between 80 and 84 were hospitalised due to flu in 2016-2017, more than any other age group
Human capital costs
However, as well as the savings to the NHS, the report, An Economic Analysis of Flu Vaccination, suggests that the government needs to looks at the economic benefits of vaccination to the country as a whole. A particularly new approach to our research was looking at how flu vaccination reduces ‘human capital costs’ – the cost of lost employment and lost care-giving.
We know that the average annual amount an older person benefits by way of informal care – generally from family members – is equivalent to £2,905 per annum if a paid care-giver had to be employed. Using this approach, our analysis suggests that the human capital costs of influenza range from £90m to £270m – a very substantial impact on the UK economy.
Vaccinations targeted for optimum impact
As flu vaccines work best in younger adults, we think more effort should be made to target the under-65s in at-risk groups. We also need to do as much as possible to raise the efficacy of flu vaccines among older age groups in particular, as this is the largest group immunised. The NHS is moving in this direction in the upcoming flu season by introducing a new vaccine which includes an adjuvant to boost the immune response in the over-65s, and in 2019-20 there will be a high dose vaccine which also aims to improve protection in older people.
Considering the administrative costs
We are a little concerned that the NHS appears to have the view that the administration costs of the programme are largely fixed while we see clear opportunities for delivering the vaccination programme more efficiently. Given that the costs of delivering a vaccine through a pharmacy are cheaper than through a GP, we think further reductions in the cost of delivery are possible, particularly for younger adults in high-risk groups. Data integration between pharmacy and GP practices is an issue, but should not be insurmountable.
It’s clear that flu vaccines remain a key part of reducing winter pressures on the NHS; they also save millions in averted lost employment and lost informal caregiving costs each year, by keeping people at work and still able to care for their families. Boosting coverage rates in the most efficient way possible is the way to ensure value for money for government and to ensure more people are protected from flu.