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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 2; 334(7604): 1134.
PMCID: PMC1885332

Flu costs the US $90bn a year, report shows

Seasonal flu costs the US economy almost $90bn (£45bn; €67bn) a year, says a new report by researchers from the US Centers for Disease Control and Prevention.Prevention.

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Annual medical costs are in excess of $10bn, and the disease accounts for more than 40 000 deaths a year, as well as 31.4 million outpatient visits involving 10.6 million patients and 3.1 million days in hospital, says the report, published online in Vaccine (doi: 10.1016/j.vaccine.2007.03.046).

Described as the first to estimate the annual economic burden of flu epidemics in the United States, the study says that such estimates are necessary to guide policy. “These results highlight the enormous annual burden of influenza,” the report says.

The authors say that immunisation can reduce the annual costs but that many people at risk still go unvaccinated.

In the study, the researchers estimated the number of cases attributable to influenza that lead to outpatient visits, admission to hospital, or death, as well as lost working time. They also used data from health insurance claims and estimated use of healthcare resources. Estimates were also made for five different age groups and for high and low risk patients.

The results, which were based on data for 2003, show that 24.7 million cases of flu occur each year, resulting in 41 008 deaths, 610 660 life years lost, and 334 185 hospital admissions.

The researchers estimated annual medical costs to be $10.4bn and the total economic burden, including 44 million working days lost because of illness, to be $87.1bn. Most of the total cost—$72.2bn (83% of the total)—is attributable to the deaths. The hospital admissions cost $6bn (7%), and the 10.6 million outpatients accounted for $6.8bn (8%).

About $4.2bn, or 40% of direct medical costs, was spent on treatment for people aged 65 years or older. Treatment for 50-64 year olds accounted for 27%, and 18% was spent on the 18-49 year olds and 15% on children. Non-medically attended cases accounted for $41.1m, less than 1% of all the medical costs.

“Immunisation against influenza can effectively reduce the annual economic burden of influenza in the United States,” the authors wrote. “Nevertheless, despite efforts to vaccinate those at highest risk of severe influenza related complications, many still go unvaccinated. Even among those that are vaccinated, some may not be adequately protected by the vaccine.”

The authors say that programmes to reduce the effect of flu on elderly US residents would probably have the greatest economic benefit, because 64% of the total economic burden arises in elderly people, including 36 000 deaths.

They added, “Further research is necessary to identify the most efficient and effective methods of minimizing influenza disease in the elderly and its contribution to the annual economic burden of influenza epidemics in the US.”

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