Economic value chain analysis for Influenza

The WHO Economic analysis value chain

National governments require economic data on the burden of influenza disease, the cost effectiveness of the vaccine, and the projected implementation costs of a maternal influenza immunization programme in their country in order to inform the allocation of limited resources and prioritization of interventions in the health sector.

WHO has developed the below resource documents to form an Economic analysis value chain, that can support countries to assess the economic and social benefits of introducing influenza vaccination or to expand existing vaccination strategies. The Economic analysis value chain comprises Economic burden analysis,


Economic burden analysis

National officials taking decisions to introduce influenza vaccines or to extending existing programmes require data on the economic burden of influenza disease in their countries in order to inform the allocation of limited resources and prioritization of interventions in the health sector. As recommended in the WHO guide for standardization of economic evaluations of immunization programmes, evaluations should ideally adopt a societal perspective, including all relevant costs and consequences of delaying the decision (Toolbox D). The economic burden of influenza encompasses multiple dimensions such as direct costs to the health service and households (e.g. hospitalization and outpatient care costs), indirect costs due to productivity losses, and broader detriments to the wider economy.

WHO’s Manual for estimating the economic burden associated with seasonal influenza outlines key conceptual frameworks, best-practice approaches and practical guidance to estimate the overall influenza economic burden. The manual’s Excel-based analysis tool can be used to generate disease-burden estimates guided by the step-by-step manual.


Economic evaluation of influenza vaccination

While analyses of cost-effectiveness of seasonal influenza vaccination have been widely assessed in high-income countries, there have been relatively few economic assessments of the value of seasonal influenza vaccination in low-resource settings. Results of economic evaluations (e.g. cost-utility analyses) should be considered for comparison of influenza vaccination with equivalent evaluations of other health programmes and efficient allocation of resources in the health-care sector.

To optimize cost-effectiveness evaluation in national settings the WHO Guidance on the economic evaluation of influenza vaccination provides analysts with robust analytical methods and outlines relevant issues that can arise when evaluating influenza vaccination strategies.


Estimating costs of introducing influenza vaccination for pregnant women

When introducing a new vaccine, the associated costs (e.g. vaccine purchase, transportation, wastage) should be estimated, as should the long-term financial requirements for the introduction.

The WHO Flutool helps to project total costs of influenza vaccine introduction for pregnant women by type of delivery strategy over a period of up to five years. The Flutool can also inform multi-year planning efforts in countries and is consistent with, and complements, the cMYP costing tool. The Flutool can be used to assess the total costs of a phased or nationwide introduction and to estimate the costs per pregnant woman immunized.


The tools described above are available at:


For more information, contact: 

Philipp Lambach, MD MBA PhD
Medical Officer, WHO