The societal and indirect economic burden of seasonal influenza in the United Kingdom
ResearchPublished Apr 27, 2023
Socioeconomic impact and societal burden of seasonal influenza, its impact on workforce productivity and provision of UK NHS services, and indirect economic costs (non-medical) due to labour-productivity losses. We undertook a literature review, a secondary database analysis, a public survey, NHS stakeholder interviews, and epidemiologic-economic modelling.
Seasonal influenza is a significant public-health issue. In the UK, the influenza season is associated with an increased demand for and pressure on the NHS. The direct health and economic impacts of seasonal influenza have received much attention. However, less attention has been given to its broader societal burden, including its indirect economic impact. We first conducted a rapid evidence assessment of the literature to understand the societal burden of seasonal influenza in the UK. Secondly, we conducted analyses of publicly available, aggregated data from NHS England and NHS Digital to better understand the impact of seasonal influenza on the provision of NHS services both before and after the COVID-19 pandemic. We also conducted a geographically representative survey of 1,000 working-age adults across the UK, who reported having influenza or caring for a dependent with influenza during at least one of the past four influenza seasons to understand impacts related to absenteeism and presenteeism in the workplace, lost wages and out-of-pocket costs. Fourthly, we conducted interviews with 20 key stakeholders within the NHS from primary care and secondary care across the four UK nations. Lastly, we used an epidemiologic-economic framework to estimate the number of influenza cases and then applied a macro-economic computable general equilibrium model to estimate the indirect economic costs associated with lost economic productivity among working-age adults who become ill with influenza.
Key Findings
- An estimated 2.4m working adults in the UK could fall ill to influenza annually, corresponding to 4.8m working days lost due to absences from or lower levels of productivity whilst at work.
- For the NHS, the influenza season is associated with an approximate average excess of 27,000 emergency inpatient admissions from A&E per month, and an average excess of 16,000 patients per month waiting more than four hours to be admitted to hospital from the A&E.
- Seasonal influenza is associated with a £644m loss to the UK's economy (0.04% of GDP), equivalent to approximately £272 per infected worker.
Recommendations
- Policies should be considered to better protect workers against lost wages when absent from work due to influenza and that workplaces could benefit from fostering cultures that discourage presenteeism.
- Improving influenza vaccine uptake — in groups recommended by the UK's NHS vaccine programme — could reduce avoidable healthcare visits during the influenza season.
- More research is needed to understand the benefits of widening the vaccine programme more broadly to working-age adults and its impact on the economic output of the UK.
- More research is needed to understand the benefits of widening the vaccine programme more broadly to working-age adults and its impact on the economic output of the UK.
Related Content
Topics
Document Details
- Copyright: RAND Corporation
- Availability: Web-Only
- Year: 2023
- Pages: 88
- DOI: https://doi.org/10.7249/RRA2165-1
- Document Number: RR-A2165-1
Citation
RAND Style Manual
Romanelli, Robert J., Mark Cabling, Zuzanna Marciniak-Nuqui, Sonja Marjanovic, Stephen Morris, Eliane Dufresne, Erez Yerushalmi, Marco Hafner, and Daniel Lee, The societal and indirect economic burden of seasonal influenza in the United Kingdom, RAND Corporation, RR-A2165-1, 2023. As of May 5, 2026: https://www.rand.org/pubs/research_reports/RRA2165-1.html
Chicago Manual of Style
Romanelli, Robert J., Mark Cabling, Zuzanna Marciniak-Nuqui, Sonja Marjanovic, Stephen Morris, Eliane Dufresne, Erez Yerushalmi, Marco Hafner, and Daniel Lee, The societal and indirect economic burden of seasonal influenza in the United Kingdom. Santa Monica, CA: RAND Corporation, 2023. https://www.rand.org/pubs/research_reports/RRA2165-1.html.
Research conducted by
The research described in this report was funded by Sanofi and conducted by RAND Europe in collaboration with the University of Cambridge, as the Cambridge Centre for Health Services Research.
This publication is part of the RAND research report series. Research reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND research reports undergo rigorous peer review to ensure high standards for research quality and objectivity.
This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited; linking directly to this product page is encouraged. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial purposes. For information on reprint and reuse permissions, please visit www.rand.org/pubs/permissions.
RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.