Every year 10% to 20% of Americans get the flu, and for elderly people the infection can be deadly. But for healthy, younger adults for whom the flu is generally not life threatening, the infection still has associated costs—health care fees, lost workdays, and quality of life concerns. Currently, flu vaccination is recommended for elderly adults, people who are chronically ill, and pregnant women, but not necessarily for healthy, younger adults. New research published in the August 20, 2002 issue of Annals of Internal Medicine suggests that flu shots are also cost-effective for healthy adults. In addition, the research suggests that the health benefits of antiviral medications to treat the flu are worth the cost of these drugs.

About the study

Researchers from Duke University and the Durham Veterans Affairs Medical Center in North Carolina used a computer model to compare the benefits of flu vaccination and treatment (if flu infection occurred) with the cost of these treatments. Within the computer model, the decision to vaccinate (yes or no) was combined with decisions to take one of three antiviral medications used to treat the flu (rimantadine [Flumadine], oseltamivir [Tamiflu], and zanamivir [Relenza]) or no medication.

The computer model also contained the following information based on national health care and labor statistics and other published research:

  • Cost of vaccination
  • Cost of each medication
  • Cost of doctor visits
  • Number of work days generally lost to an episode of flu infection
  • Average cost for each lost work day

Researchers also surveyed 210 patients at a primary care clinic in North Carolina to determine their willingness to pay for symptom relief and for medications with fewer side effects, such as nausea and dizziness. This information was entered into the computer model, as well.

By running the computer model with various combinations of flu vaccination (yes or no), medications or no medication, and the willingness-to-pay data, researchers compared the money spent on flu shots and medications with the money that could be saved by keeping people healthy.

The findings

Overall, the health benefits of vaccination provided a cost benefit over non-vaccination, and the health benefits of antiviral medications equaled or exceeded their costs. The most cost-beneficial strategy was to get vaccinated and, if you got the flu, take rimantadine. According to the model, getting a flu shot and taking rimantadine (if flu developed) costs $30.97 less than not getting a flu shot and not taking rimantadine if you got the flu.

Although these results are interesting, this study has its limitations. First, computer modeling of this kind relies on estimates and a number of assumptions. Although this model is helpful for identifying potential cost-benefit trends, the findings warrant further investigation in controlled studies of people who do or do not receive vaccination and antiviral drugs. Second, this study only compared the cost-effectiveness of the three antiviral drugs, but not the effectiveness of each drug in treating flu symptoms. Third, the willingness-to-pay variables might be affected by external factors not considered in this model, such as income.

How does this affect you?

Should you get a flu shot this fall? The findings of this study suggest that, even if you are a healthy adult, a flu shot is a cost-effective way to reduce your chances of getting the flu. Flu shots cost less than the cost of flu treatment and lost workdays. And, if you’re unfortunate enough to get the flu anyway, this computer model found that antiviral drugs are worth the money they cost in terms of saving you lost workdays and unpleasant symptoms.