Vaccine presentation in the USA: economics of prefilled syringes versus multidose vials for influenza vaccination

Abstract

In the USA, influenza vaccines are available as parenteral injections or as an intranasal preparation. Injectable influenza vaccines are available in either multidose vial (MDV), single-dose vial or prefilled syringe (PFS) presentations. PFSs have gained market share in the USA but have not yet reached the levels of uptake currently seen in Western Europe. Here, we review the topic of vaccine presentation in the USA, with a special focus on influenza vaccines. Second, we present the results of a time-motion study that measured administration costs of influenza vaccination comparing MDVs versus PFSs during the 2009/2010 influenza campaign. Vaccinating with MDVs took an average 37.3 s longer than PFSs. The cost of administering 1000 immunizations in 2009 using MDVs were US$8596 versus US$8920.21 using PFSs. In a pandemic situation where 300 million Americans would require vaccination, PFSs would save 3.12 million h in healthcare worker time, worth US$111.1 million. The higher acquisition costs of PFS vaccines compared with MDVs are offset by lower administrative costs and increased safety.

Keywords::

• costs
• immunization
• influenza vaccine
• multidose vials
• prefilled syringes
• time motion
• vaccine administration

Acknowledgments

The authors would like to thank the practices and nurses who kindly allowed us to observe their work and routine. They also acknowledge the helpful comments received from Brian Lynch, Nuphar Rozen-Adler, Justin Wright and Jennifer Zolot.

Financial & competing interests disclosure

The study was funded by a grant from Becton, Dickinson & Company. The authors have received a grant from Becton, Dickinson and Company. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

The authors state that the study received IRB exempt status from the Johns Hopkins Bloomberg School of Public Health Internal Review Board. Even though the IRB declared the study to be exempt, the investigators obtained consent from each participant.