Cost-minimization analysis of the U.S. Army accession screening and immunization program.

OBJECTIVES Significant Army resources are utilized to identify nonimmune recruits for targeted vaccinations against hepatitis A, hepatitis B, measles, rubella, and varicella. Therefore, a cost-minimization analysis between the Accession Screening and Immunization Program (ASIP) and the previously utilized universal vaccination program will assist military public health policy makers in decisions that enhance force health protection. METHODS Serological immunity data on 41,146 Fort Leonard Wood, Missouri, Army basic training recruits aged 17 to 42 years from October 1, 2007 to September 30, 2009 were utilized. Vaccination, serology, and other direct and indirect costs were determined using the Federal Supply Schedule and local base immunization data. TreeAge Pro 2009 version 1.0.2 was used for the analysis. RESULTS The cumulative annual cost for the universal vaccination program totaled $1,504,587, whereas the cumulative costs for the ASIP totaled $1,094,025, for a cost-savings of $410,561 annually at this basic training site. CONCLUSIONS Over $400,000 of annual savings was realized from the ASIP compared to universal vaccination at Fort Leonard Wood, thus confirming the cost-savings theorized by the implementation of the ASIP.