Molinari · Vaccine 2007 · probabilistic economic modeling study · n=2003 US population (model-based)

The annual impact of seasonal influenza in the US: measuring disease burden and costs.

Cited 1748 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Mathematical simulation and economic modeling using secondary epidemiological and claims data

PubMed 17544181 · doi:10.1016/j.vaccine.2007.03.046 · record verified 2026-08-31

What was done

Constructed a probabilistic model using publicly available epidemiological data and health insurance claims to estimate age- and risk-specific seasonal influenza burden for the 2003 US population. The model projected influenza-attributable outpatient visits, hospital days, premature deaths, and work absenteeism, calculating direct medical expenses and indirect productivity losses (based on lost earnings and statistical life values) in 2003 US dollars.

What was found

Annual influenza epidemics resulted in an average of 610,660 undiscounted life-years lost, 3.1 million hospitalized days, and 31.4 million outpatient visits. Direct medical costs averaged $10.4 billion (95% CI, $4.1 to $22.2 billion) per year. Annual lost earnings from illness and mortality totaled $16.3 billion (95% CI, $8.7 to $31.0 billion). Total economic burden based on statistical life values was estimated at $87.1 billion (95% CI, $47.2 to $149.5 billion), with productivity and mortality losses forming the majority of the cost.

Why it matters

This study provides a comprehensive baseline for the total economic impact of seasonal influenza in the US, demonstrating that indirect societal costs from missed work and premature mortality substantially exceed direct medical expenditures.

Limits

The findings are derived from mathematical modeling and claims databases rather than direct prospective tracking, leaving results sensitive to coding inaccuracies and underlying model assumptions. Confidence intervals are wide (e.g., $47.2 to $149.5 billion for total economic burden), and estimates reflect US cost structures and population parameters from 2003.

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