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

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.