WEDNESDAY, Sept. 3, 2003 (HealthDayNews) -- Giving seniors drugs to fight the flu can cut treatment costs as well as the risk of complications and hospitalization.
But the new study making the claim also stresses that vaccination remains the best strategy for this age group.
Vaccination decreases the likelihood of getting the flu and reduces hospitalization by one-third and mortality by half, the researchers report in the new issue of the Annals of Internal Medicine.
The study looked at published information and computer models to compare strategies for caring for patients over 65 with flu-like illness.
The researchers found treatment with the flu drug oseltamivir (Tamiflu) proved cost-effective for patients over 65 who had flu-like symptoms during flu season but who had not been vaccinated or were considered at high risk for complications. High-risk patients include those with heart or lung disease.
But during flu season, patients who have been vaccinated and are considered at low risk for complications should be tested for flu, then given medication only if flu is detected, the study recommends.
Previous research has found treating younger adults with flu drugs is cost-effective because it cuts lost work time, the researchers say. Until now, however, the cost-effectiveness of flu medication among older adults remained unknown.
To determine the cost-effectiveness of treating older patients, the researchers weighed direct medical costs, including doctor visits, diagnostic tests, medications and hospitalization.
Study author Dr. Michael B. Rothberg says complications from the flu, such as pneumonia, typically lead to hospitalization and flu drugs can reduce such complications.
"In that case, the cost of the drugs may turn out to be very little compared with the cost of hospitalization for complications," says Rothberg, an internist at Baystate Medical Center in Springfield, Mass.
Doctors are often hesitant to prescribe flu drugs because they're expensive and won't work if the patient has a virus other than the flu, Rothberg says. He also notes that flu medication works only if taken within 48 hours of the first symptoms.
The benefits of flu medication notwithstanding, Rothberg stresses the vital importance of vaccinations for those over 65. Vaccines cost less and are more effective than treatment, he says, and vaccinated patients live longer and incur fewer expenses than non-vaccinated patients.
"Everyone over 65 needs to be vaccinated, and I can't stress that enough," Rothberg says.
Flu sends about 114,000 Americans to hospitals and kills about 36,000 each year, the U.S. Centers for Disease Control and Prevention (CDC) says. More than 90 percent of the deaths occur among people 65 and older.
But only about two-thirds of Americans 65 and older have gotten annual flu vaccinations in the past three years, says Dr. Carolyn Bridges, a medical epidemiologist in the CDC's National Immunization Program.
A few mild flu seasons recently may have kept some from getting vaccinations, Bridges says.
"Sometimes, people's memories are short," she says. "I think, in part, sometimes we forget how severe influenza can be, and that may contribute to some vaccination rates not being as high as we'd like to see them."
The CDC strongly recommends flu vaccines for anyone 6 months old or older who is at "increased risk" for complications from the flu. This includes people 65 and older.
Vaccines also are recommended for:
- people with chronic, long-term health problems such as heart or lung disease, kidney problems, diabetes, asthma, anemia, HIV infection, AIDS or any other illness that suppresses the immune system;
- people aged 50 to 64 years because this group has an increased prevalence of "high-risk" conditions;
- health-care workers and others in close contact with those at high risk, to reduce the possibility of transmitting the flu;
- children aged 6 to 23 months old, their household contacts and caregivers.
The CDC says there will be enough flu vaccine this year, so anyone who wants to get vaccinated should be able to do so as soon as the vaccine becomes available in October.
Production and distribution of the flu vaccine was delayed in 2000 and 2001, prompting the CDC to recommend that people 65 and older and people at high risk for complications from the flu get the vaccine first. Others were urged to wait until November to receive vaccines.
Flu season typically runs from November through March or beyond. The flu season has peaked in January or later during 22 of the past 26 flu seasons, the CDC says.
More information
For more on the flu, visit the U.S. Centers for Disease Control and Prevention or the National Coalition for Adult Immunization.
