TABLE 5

Cost Analysis of Clinician and Family Focused Decision Support

Total Cost of Interventiona,bPercent VaccinatedNumber VaccinatedcIncremental Cost Compared With Next Less Expensive InterventiondIncremental Number of Girls VaccinateddIncremental Cost/Incremental Number Vaccinated
HPV 1
 No intervention$015647
 Family-focused decision support$1349 ($185 for programming of rosters and $1164 for telephone calls)16723$134976$18
 Clinician decision support$2496 ($2122 for programming costs, $140 for feedback report delivery, and $234 for education sessions)21928$1147205$6
 Combined intervention$3842 (fixed costs listed above [$2496 and $185] and $1161 for telephone calls)22984$134756$24
HPV #2
 No intervention$055623
 Family-focused decision support$543 ($185 for programming of rosters, $358 for telephone calls)60679$54356$10
 Clinician decision support$2496 ($2122 for programming costs, $140 for feedback report delivery, and $234 for education sessions)55622Dominated
 Combined intervention$3061 (fixed costs listed above [$2496 and $185], and $380 for telephone calls)65738$251859$42
HPV #3
 No intervention$051579
 Family-focused decision support$563 ($185 for programming of rosters, $378 for telephone calls)59677$56398$6
 Clinician decision support$2496 ($2122 for programming costs, $140 for feedback report delivery, and $234 for education sessions)53602Dominated
 Combined intervention$3043 (fixed costs listed above [$2496 and $185], and $362 for telephone calls)60690$248013$189
  • a To focus on our primary outcome, Tdap and meningococcal conjugate vaccines were not accounted for in this analysis. Benefits for these or other vaccines due among adolescents could reduce the costs associated with implementing the intervention.

  • b Fixed costs included programming costs ($19 096 total), feedback report delivery ($420 total), and education sessions for the clinician-focused intervention ($2112 total), and programming of daily rosters for the family-focused intervention ($1670 total). All fixed costs were spread over 3 years except feedback report delivery, and fixed costs were split equally between the 3 HPV vaccine doses. Fixed costs were split across 3 years because the costs of health information technology interventions are generally recovered over several years. Variable costs included the cost of using Televox (Mobile, AL) to make the family-focused reminder telephone calls. Each call cost $0.16.

  • c The number of girls eligible for vaccine was different in each intervention arm. Therefore, to calculate the incremental cost per incremental number vaccinated, the number of girls vaccinated in each arm was always calculated based on the same denominator (the number of eligible girls in the no intervention group).

  • d When an intervention was dominated, the incremental cost and incremental number of girls vaccinated were compared with the next less expensive nondominated intervention.

  • — indicates not applicable.