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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 30 Research Studies DisplayedFerranna M, Robinson LA, Cadarette D
The benefits and costs of U.S. employer COVID-19 vaccine mandates.
This study examined the benefits and costs of U.S. employer COVID-19 mandates for federal employees and contractors and for some healthcare and private sector workers if there had not been major challenges in court that halted or delayed the mandates. The authors estimated the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, they found that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. They examined scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, and found that the estimated net benefits are potentially large. They estimated that they reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. For other scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates' benefits are unlikely to exceed their costs. They believe that mandates may be most useful when the consequences of inaction are catastrophic. However, they did not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation.
AHRQ-funded; HS000055.
Citation: Ferranna M, Robinson LA, Cadarette D .
The benefits and costs of U.S. employer COVID-19 vaccine mandates.
Risk Anal 2023 Oct; 43(10):2053-68. doi: 10.1111/risa.14090..
Keywords: COVID-19, Vaccination, Healthcare Costs
Cox SN, Wedlock PT, Pallas SW
A systems map of the economic considerations for vaccination: application to hard-to-reach populations.
The authors developed a systems map of the mechanisms involved in vaccination, and associated costs and benefits, focused at the service delivery level, in order to identify the mechanisms that may be different for hard-to-reach populations. They concluded that decision-makers can use this systems map to understand where steps in the vaccination process may be interrupted or weak and identify where gaps exist in the understanding of the economics of vaccination. With improved understanding of system-wide effects, their map can help decision-makers inform targeted interventions and policies to increase vaccination coverage in hard-to-reach populations.
AHRQ-funded; HS023317; HS028165.
Citation: Cox SN, Wedlock PT, Pallas SW .
A systems map of the economic considerations for vaccination: application to hard-to-reach populations.
Vaccine 2021 Nov 5;39(46):6796-804. doi: 10.1016/j.vaccine.2021.05.033..
Keywords: Vaccination, Healthcare Costs
Bartsch SM, O'Shea KJ, Wedlock PT
The benefits of vaccinating with the first available COVID-19 coronavirus vaccine.
This study’s objective was to determine quantitatively the benefits of early vaccination for COVID-19 even if later on in the pandemic a latter vaccine has substantially higher efficacy. The team developed this model in 2020 before vaccinations became available. For example if a vaccine with 50% efficacy becomes available when 10% of the population has already been infected, waiting until 40% of the population are infected for a vaccine with 80% efficacy results in 15.6 million additional cases and 1.5 million additional hospitalizations, costing $20.6 billion more in direct medical costs and $12.4 billion more in productivity losses.
AHRQ-funded; HS028165.
Citation: Bartsch SM, O'Shea KJ, Wedlock PT .
The benefits of vaccinating with the first available COVID-19 coronavirus vaccine.
Am J Prev Med 2021 May;60(5):605-13. doi: 10.1016/j.amepre.2021.01.001..
Keywords: COVID-19, Vaccination, Healthcare Costs, Prevention, Infectious Diseases
Bartsch SM, O'Shea KJ, Wedlock PT
Potential clinical and economic value of norovirus vaccination in the community setting.
This paper examined the potential clinical and economic value of norovirus vaccination in a community setting using a transmission, clinical, and economics computation simulation model representing different U.S. population segments. The simulation looked at the impact of vaccinating children <5 years and older adults aged 65 and older. Compared with no vaccine, vaccinating preschool-aged children averted 8-7% of symptomatic norovirus cases in a community and vaccinating older adults averted 2-29% of symptomatic cases. Vaccination with a 25% vaccine efficacy was cost effective when vaccinations cost ≤$445 and cost saving at ≤$370 when vaccinating preschool-aged children and ≤$42 and ≤$30, respectively for older adults. With 50% efficacy, vaccination was cost effective when it cost ≤$1,190 and cost saving at ≤$930 when vaccinating preschool-aged children and ≤$110 and ≤$64, respectively, for older adults. At 75% vaccine efficacy the cost thresholds increased to ≤$1,600 and ≤$1,300 for preschool-aged children and ≤$165 and ≤$100 for older adults.
AHRQ-funded; HS023317.
Citation: Bartsch SM, O'Shea KJ, Wedlock PT .
Potential clinical and economic value of norovirus vaccination in the community setting.
Am J Prev Med 2021 Mar;60(3):360-68. doi: 10.1016/j.amepre.2020.10.022..
Keywords: Infectious Diseases, Vaccination, Healthcare Costs
Bartsch SM, Stokes-Cawley OJ, Buekens P
The potential economic value of a therapeutic Chagas disease vaccine for pregnant women to prevent congenital transmission.
Currently, there are no solutions to prevent congenital transmission of Chagas disease during pregnancy, which affects 1-40% of pregnant women in Latin America and is associated with a 5% transmission risk. In this study the investigators sought to determine the economic value of therapeutic vaccines to prevent congenital transmission. The investigators delineated the thresholds at which therapeutic vaccination of Chagas-positive pregnant women would be cost-effective and cost-saving, providing economic guidance for decision-makers to consider when developing and bringing such a vaccine to market.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Stokes-Cawley OJ, Buekens P .
The potential economic value of a therapeutic Chagas disease vaccine for pregnant women to prevent congenital transmission.
Vaccine 2020 Apr 3;38(16):3261-70. doi: 10.1016/j.vaccine.2020.02.078..
Keywords: Vaccination, Healthcare Costs, Pregnancy, Women
Bartsch SM, Asti L, Stokes-Cawley OJ
The potential economic value of a Zika vaccine for a woman of childbearing age.
The authors mapped the Zika vaccine and vaccination characteristic thresholds at which vaccination becomes cost effective, highly cost effective, and cost saving. They developed a Markov model to simulate a woman of childbearing age to follow the potential risk and clinical course of a Zika infection. They found that, in some cases, the vaccine was cost effective when the risk was as low as 0.015%, the cost was as high as $7,500, the efficacy was as low as 25%, and the duration of protection was 1 year. They concluded that the thresholds at which vaccination becomes cost effective and cost saving can provide targets for Zika vaccine development and implementation.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Asti L, Stokes-Cawley OJ .
The potential economic value of a Zika vaccine for a woman of childbearing age.
Am J Prev Med 2020 Mar;58(3):370-77. doi: 10.1016/j.amepre.2019.10.023..
Keywords: Vaccination, Women, Infectious Diseases, Public Health, Healthcare Costs, Prevention
Bartsch SM, Asti L, Cox SN
What is the value of different Zika vaccination strategies to prevent and mitigate Zika outbreaks?
The authors developed models of Honduras, Brazil, and Puerto Rico, simulated targeting different populations for Zika vaccination, and then introduced various Zika outbreaks. Their models showed that, when considering transmission, while vaccinating everyone naturally averted the most cases, specifically targeting women of childbearing age or young adults was the most cost-effective.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Asti L, Cox SN .
What is the value of different Zika vaccination strategies to prevent and mitigate Zika outbreaks?
J Infect Dis 2019 Aug 9;220(6):920-31. doi: 10.1093/infdis/jiy688..
Keywords: Healthcare Costs, Vaccination, Public Health, Infectious Diseases
Adamson B, Garrison L, Barnabas RV
Competing biomedical HIV prevention strategies: potential cost-effectiveness of HIV vaccines and PrEP in Seattle, WA.
The authors estimated the cost-effectiveness of HIV vaccines considering their potential interaction with pre-exposure prophylaxis (PrEP) and condom use. They concluded that access to an HIV vaccine is desirable, as it could increase the overall effectiveness of combination HIV prevention efforts and improve population health. They recommended carefully considering the design of policies that guide interactions between vaccine and PrEP utilization and potential competition when planning for the rollout and scale-up of HIV vaccines.
AHRQ-funded; HS013853.
Citation: Adamson B, Garrison L, Barnabas RV .
Competing biomedical HIV prevention strategies: potential cost-effectiveness of HIV vaccines and PrEP in Seattle, WA.
J Int AIDS Soc 2019 Aug;22(8):e25373. doi: 10.1002/jia2.25373..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Costs, Vaccination
Bartsch SM, Bottazzi ME, Asti L
Economic value of a therapeutic Chagas vaccine for indeterminate and Chagasic cardiomyopathy patients.
Therapeutic vaccines to prevent Chagas disease progression to cardiomyopathy are under development because the only available medications (benznidazole and nifurtimox) are limited by their efficacy, long treatment course, and side effects. Better understanding the potential clinical and economic value of such vaccines can help guide development and implementation. In this study, the investigators developed a computational Chagas Markov model to evaluate the clinical and economic value of a therapeutic vaccine given in conjunction with benznidazole in indeterminate and chronic Chagas patients.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Bottazzi ME, Asti L .
Economic value of a therapeutic Chagas vaccine for indeterminate and Chagasic cardiomyopathy patients.
Vaccine 2019 Jun 19;37(28):3704-14. doi: 10.1016/j.vaccine.2019.05.028..
Keywords: Vaccination, Healthcare Costs
Yoo BK, Schaffer SJ, Humiston SG
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
This paper describes a clinical trial which created a school-located influenza vaccination (SLIV) program in upstate New York. Researchers wanted to determine if this was a cost-effective alternative to vaccination in primary care practices. Two groups of students were vaccinated – one in an elementary school and the other in a secondary school. Secondary school vaccinations were more cost-effective than elementary schools with a lower median cost per vaccination. The authors concluded that it does raise vaccination rates, but it is not cost-effective due to the higher costs for consent systems and project coordination.
AHRQ-funded; HS021163.
Citation: Yoo BK, Schaffer SJ, Humiston SG .
Cost effectiveness of school-located influenza vaccination programs for elementary and secondary school children.
BMC Health Serv Res 2019 Jun 24;19(1):407. doi: 10.1186/s12913-019-4228-5..
Keywords: Children/Adolescents, Education, Healthcare Costs, Influenza, Public Health, Vaccination
Wedlock PT, Mitgang EA, Oron AP
Modeling the economic impact of different vial-opening thresholds for measles-containing vaccines.
The lack of specific policies on how many children must be present at a vaccinating location before a healthcare worker can open a measles-containing vaccine (MCV) - i.e. the vial-opening threshold - has led to inconsistent practices, which can have wide-ranging systems effects. Using HERMES-generated simulation models of the routine immunization supply chains of Benin, Mozambique and Niger, the investigators evaluated the impact of different vial-opening thresholds (none, 30% of doses must be used, 60%) and MCV presentations (10-dose, 5-dose) on each supply chain.
AHRQ-funded; HS023317.
Citation: Wedlock PT, Mitgang EA, Oron AP .
Modeling the economic impact of different vial-opening thresholds for measles-containing vaccines.
Vaccine 2019 Apr 17;37(17):2356-68. doi: 10.1016/j.vaccine.2019.03.017..
Keywords: Vaccination, Infectious Diseases, Healthcare Costs, Public Health
Bartsch SM, Taitel MS, DePasse JV
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. In this paper, the investigators utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Taitel MS, DePasse JV .
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
Vaccine 2018 Nov 12;36(46):7054-63. doi: 10.1016/j.vaccine.2018.09.040..
Keywords: Healthcare Costs, Influenza, Provider: Pharmacist, Public Health, Vaccination
de Montigny S, Adamson BJS, Masse BR
Projected effectiveness and added value of HIV vaccination campaigns in South Africa: a modeling study.
Sci Rep 2018 Apr 17;8(1):6066. doi: 10.1038/s41598-018-24268-4.
In this paper, the authors estimated the potential epidemiological and economic impact of HIV vaccine campaigns compared to continuous vaccination, assuming that vaccine efficacy was transient and dependent on immune response. The investigators concluded that results suggested a partially effective HIV vaccine would have substantial impact on the HIV epidemic in South Africa and offer good value if priced less than $105 for a five-dose series. They suggested that vaccination campaigns every two years may offer greater value for money than continuous vaccination reaching the same coverage level.
In this paper, the authors estimated the potential epidemiological and economic impact of HIV vaccine campaigns compared to continuous vaccination, assuming that vaccine efficacy was transient and dependent on immune response. The investigators concluded that results suggested a partially effective HIV vaccine would have substantial impact on the HIV epidemic in South Africa and offer good value if priced less than $105 for a five-dose series. They suggested that vaccination campaigns every two years may offer greater value for money than continuous vaccination reaching the same coverage level.
AHRQ-funded; HS013853.
Citation: de Montigny S, Adamson BJS, Masse BR .
Projected effectiveness and added value of HIV vaccination campaigns in South Africa: a modeling study.
Sci Rep 2018 Apr 17;8(1):6066. doi: 10.1038/s41598-018-24268-4..
Keywords: Health Services Research (HSR), Healthcare Costs, Human Immunodeficiency Virus (HIV), Public Health, Vaccination
Anderson LJ, Shekelle P, Keeler E
The cost of interventions to increase influenza vaccination: a systematic review.
This study sought to systematically review economic evaluations of healthcare-based quality improvement interventions for improving influenza vaccination uptake among general populations and healthcare workers. The investigators concluded that quality improvement interventions for influenza vaccination involved per-enrollee costs that were similar to the cost of the vaccine itself ($11.78-$36.08/dose). They suggested that based on limited available evidence in general populations, quality improvement interventions may be cost saving to cost effective for the health system.
AHRQ-funded; HS022644.
Citation: Anderson LJ, Shekelle P, Keeler E .
The cost of interventions to increase influenza vaccination: a systematic review.
Am J Prev Med 2018 Feb;54(2):299-315. doi: 10.1016/j.amepre.2017.11.010..
Keywords: Healthcare Costs, Influenza, Quality Improvement, Vaccination
Leshem E, Tate JE, Steiner CA
AHRQ Author: Steiner. CA
National estimates of reductions in acute gastroenteritis-related hospitalizations and associated costs in US children after implementation of rotavirus vaccines.
The study compared acute gastroenteritis (AGE)-related hospitalization rates among children <5 years of age during the pre-rotavirus vaccine (2000-2006) and post-rotavirus vaccine (2008-2013) periods to estimate national reductions in AGE-related hospitalizations and associated costs.
AHRQ-authored
Citation: Leshem E, Tate JE, Steiner CA .
National estimates of reductions in acute gastroenteritis-related hospitalizations and associated costs in US children after implementation of rotavirus vaccines.
J Pediatric Infect Dis Soc 2017 Aug 17;7(3):257-60. doi: 10.1093/jpids/pix057..
Keywords: Children/Adolescents, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Vaccination
Lee BY, Wedlock PT, Haidari LA
Economic impact of thermostable vaccines.
Using simulation models of the vaccine supply chains for the Republic of Benin, the state of Bihar (India), and Niger, the researchers simulated replacing different existing vaccines with thermostable formulations and determined the resulting clinical and economic impact. They concluded that medical cost and productivity savings could outweigh even significant price premiums charged for thermostable formulations of vaccines, providing support for their use.
AHRQ-funded; HS023317.
Citation: Lee BY, Wedlock PT, Haidari LA .
Economic impact of thermostable vaccines.
Vaccine 2017 May 25;35(23):3135-42. doi: 10.1016/j.vaccine.2017.03.081.
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Keywords: Vaccination, Healthcare Costs
Adamson BJS, Carlson JJ, Kublin JG
The potential cost-effectiveness of pre-exposure prophylaxis combined with HIV vaccines in the United States.
This economic evaluation found that at current prices, pre-exposure prophylaxis (PrEP) was not cost-effective alone or in combination. A combination strategy had the greatest health benefit but was not cost-effective as compared to vaccination alone. Vaccine durability and PrEP drug prices were key drivers of cost-effectiveness.
AHRQ-funded; HS013853.
Citation: Adamson BJS, Carlson JJ, Kublin JG .
The potential cost-effectiveness of pre-exposure prophylaxis combined with HIV vaccines in the United States.
Vaccines 2017 May 24;5(2). doi: 10.3390/vaccines5020013.
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Keywords: Human Immunodeficiency Virus (HIV), Vaccination, Healthcare Costs, Prevention
Haidari LA, Brown ST, Wedlock P
When are solar refrigerators less costly than on-grid refrigerators: a simulation modeling study.
Gavi the Vaccine Alliance recommends solar refrigerators for vaccine storage in areas with less than eight hours of electricity per day, and World Health Organization guidelines are more conservative. This study investigated whether solar refrigerators provide value where electrical outages are less frequent. It identified the frequency and duration at which electrical outages need to occur for solar refrigerators to provide savings in total cost per dose administered over electric refrigerators at different solar refrigerator prices.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Wedlock P .
When are solar refrigerators less costly than on-grid refrigerators: a simulation modeling study.
Vaccine 2017 Apr 19;35(17):2224-28. doi: 10.1016/j.vaccine.2016.11.103.
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Keywords: Healthcare Costs, Medication, Vaccination
Haidari LA, Brown ST, Constenla D
Geospatial planning and the resulting economic impact of human papillomavirus vaccine introduction in Mozambique.
Researchers developed the Strategic Integrated Geo-temporal Mapping Application) to determine the potential economic impact of HPV immunization in Mozambique. If each health center covers a catchment area with a 5-km radius, then 40 percent of the target population could be reached to prevent 50 cases, 178 disability-adjusted life years, and US $202,854 in health care costs and lost productivity.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Constenla D .
Geospatial planning and the resulting economic impact of human papillomavirus vaccine introduction in Mozambique.
Sex Transm Dis 2017 Apr;44(4):222-26. doi: 10.1097/olq.0000000000000574.
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Keywords: Cancer, Healthcare Costs, Infectious Diseases, Sexual Health, Vaccination
Adamson B, Dimitrov D, Devine B
The potential cost-effectiveness of HIV vaccines: a systematic review.
The aim of this paper was to review and compare HIV vaccine uncertainty in model, methodology, and parameterization. Model assumptions about vaccine price, HIV treatment costs, epidemic context, and willingness to pay influenced results more consistently than assumptions on HIV transmission dynamics.
AHRQ-funded; HS013853.
Citation: Adamson B, Dimitrov D, Devine B .
The potential cost-effectiveness of HIV vaccines: a systematic review.
Pharmacoeconom Open 2017 Mar;1(1):1-12. doi: 10.1007/s41669-016-0009-9.
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Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Vaccination
Fitzpatrick MC, Shah HA, Pandey A
One Health approach to cost-effective rabies control in India.
The authors developed a data-driven rabies transmission model fit to human rabies autopsy data and human rabies surveillance data from Tamil Nadu, India. They found that highly feasible strategies focused on stray dogs, vaccinating as few as 7% of dogs annually, could very cost-effectively reduce human rabies deaths by 70% within 5 years, and a modest expansion to vaccinating 13% of stray dogs could cost-effectively reduce human rabies by almost 90%. Futher, if owners are willing to bring dogs to central point campaigns at double the rate that campaign teams can capture strays, expanded annual targets become cost-effective.
AHRQ-funded; HS000055.
Citation: Fitzpatrick MC, Shah HA, Pandey A .
One Health approach to cost-effective rabies control in India.
Proc Natl Acad Sci U S A 2016 Dec 20;113(51):14574-81. doi: 10.1073/pnas.1604975113.
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Keywords: Healthcare Costs, Infectious Diseases, Prevention, Vaccination
Haidari LA, Brown ST, Constenla D
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
The researchers assessed how well tetanus toxoid (TT) immunization locations meet population demand in Mozambique. They found that TT immunization locations are not geographically accessible by a significant proportion of pregnant women, resulting in substantial healthcare and productivity costs that could potentially be averted by adding or reconfiguring TT immunization locations.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Constenla D .
The economic value of increasing geospatial access to tetanus toxoid immunization in Mozambique.
Vaccine 2016 Jul 29;34(35):4161-65. doi: 10.1016/j.vaccine.2016.06.065.
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Keywords: Access to Care, Healthcare Costs, Health Services Research (HSR), Pregnancy, Vaccination
Haidari LA, Brown ST, Ferguson M
The economic and operational value of using drones to transport vaccines.
Using a simulation model, the researchers performed sensitivity analyses to assess the impact of using an unmanned aerial system (UAS) for routine vaccine distribution under a range of circumstances . They found that implementing a UAS could increase vaccine availability and decrease costs in a wide range of settings and circumstances if the drones are used frequently enough to overcome the capital costs of installing and maintaining the system.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Ferguson M .
The economic and operational value of using drones to transport vaccines.
Vaccine 2016 Jul 25;34(34):4062-7. doi: 10.1016/j.vaccine.2016.06.022.
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Keywords: Health Information Technology (HIT), Healthcare Costs, Vaccination
Bartsch SM, Hotez PJ, Hertenstein DL
Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting.
The authors evaluated the potential economic and epidemiologic impact of a preventive hookworm vaccine. A pediatric hookworm vaccine drastically decreased hookworm prevalence in children. A booster in adulthood further reduced the overall prevalence and nearly eliminated hookworm infection in children. The authors conclude that a human hookworm vaccine would provide both health benefits and cost savings.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Hotez PJ, Hertenstein DL .
Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting.
Vaccine 2016 Apr 27;34(19):2197-206. doi: 10.1016/j.vaccine.2016.03.018.
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Keywords: Vaccination, Healthcare Costs, Children/Adolescents, Newborns/Infants
Eaton EF, Kulczycki A, Saag M
Immunization costs and programmatic barriers at an urban HIV clinic.
This study estimated costs of providing Gardasil, Prevnar, and Zostavax to eligible patients at a US Ryan White Part C academically affiliated HIV clinic in 2013. Its cost analysis of 3 vaccines showed great variation in insurance coverage, with potential losses of almost $100 000 for one HIV clinic if eligible patients received vaccinations in one calendar year.
AHRQ-funded; HS013852.
Citation: Eaton EF, Kulczycki A, Saag M .
Immunization costs and programmatic barriers at an urban HIV clinic.
Clin Infect Dis 2015 Dec;61(11):1726-31. doi: 10.1093/cid/civ637.
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Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Medication, Vaccination