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The Great Pulse Patient Survey

Giving all patients aged 50 to 64 the flu vaccine would be cost-effective and should be considered by the Department of Health, a new UK study concludes.

The department said its advisory group on flu vaccination would be examining the data as part of a wider review of evidence for vaccination in the age group.

Pulse reported in July that the influenza subgroup of the Joint Committee on Vaccination and Immunisation had decided to look at the controversial issue afresh.

The new study, to be published in Vaccine, found the estimated cost per quality-adjusted life-year was £6,174 for NHS costs and £10,766 for all costs. If an incentive payment to GPs of £7.28 was included, then the total cost per quality-adjusted life-year rose to £17,862 ­ still well below the standard £30,000 threshold.

'We believe the JCVI should consider a lowering of the UK age-related policy of flu vaccination from 65 to 50 and that our model and findings could be applied more widely,' the researchers concluded.

'We consider that further work is required on estimating the burden of flu so the benefits of vaccination can be estimated more precisely.'

Study leader David Turner, a research fellow in health economics at the University of Leicester, said: 'Our conclusion is that extending the vaccination downwards may represent a cost-effective change in strategy. It's something we should at least be considering.'

The study ­ one of the first to be based on UK hospital admissions data ­ modelled the effects of flu vaccination in people aged 50 to 64. It estimated vaccination would prevent 4,508 cases per 100,000 people vaccinated each flu season, for a net cost to the NHS of £653,221.

The net cost increased to £1.1million when non-NHS costs were taken into account.

Dr Douglas Fleming, a member of the JCVI influenza subgroup and a GP in Birmingham, said the issue remained on the agenda, but the group had not yet been persuaded that extending the programme would be cost-effective because of lack of appropriate UK data.

Dr Fleming said: 'This paper provides a new opportunity to return to the subject.'

By Nerys Hairon

How flu campaign has expanded

October 2002 DoH orders PCTs to meet 70

per cent uptake in over-65s

February 2003 GPs ordered to set up registers

of high-risk under 65s

March 2003 Flu vaccination payment to

cover at-risk under-65s in nGMS


November 2003 GPs told to step up flu

vaccination in at-risk children

July 2004 JCVI expands vaccination to all

children admitted to hospital for

respiratory infections in past year

August 2005 Government extends flu

campaign to cover patients with

chronic liver disease and carers

of elderly and disabled people

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