Cost-effectiveness of influenza immunization in adult cancer patients in Taiwan.

The aim of this study was to investigate the efficacy of the influenza vaccine among cancer patients in Taiwan. We determined the effect of immunization on the following outcomes of disease: hospitalizations, emergency department visits, hospital outpatient visits, physician office visits, and deaths. Cost-effectiveness was analysed from the perspectives of the healthcare system and society. A decision tree was used, with estimates of disease burden and costs based on data from published and unpublished sources. The model followed 34 112 cancer patients aged 20-64 years who were registered by the Taiwan National Cancer Registry in 2002. An influenza immunization programme for the cancer population would prevent 2555 cases of all types of influenza infection, 660 of which would be serious cases involving hospitalization, emergency department visits and death. From the perspective of the healthcare system, the programme would cost US$7.7 million, providing net savings of US$5.4 million. From a societal perspective, the programme would cost US$28.6 million, providing net savings of US$22.3 million. This corresponds to savings of US$2107 and US$6338 per case averted, from healthcare and societal perspectives, respectively, as well as 110 lives saved. Lesser disease burden, greater vaccine efficacy and lower cost of hospitalizations increased cost-effectiveness. Influenza immunization for cancer patients is cost-saving and cost-effective from a healthcare and societal perspective in Taiwan. We highly recommend annual influenza vaccinations for this patient group.