Valuing the cost of improving Chilean primary vaccination: a cost minimization analysis of a hexavalent vaccine

BMC Health Serv Res. 2020 Apr 9;20(1):295. doi: 10.1186/s12913-020-05115-7.

Abstract

Background: The phased withdrawal of oral polio vaccine (OPV) and the introduction of inactivated poliovirus vaccine (IPV) is central to the polio 'end-game' strategy.

Methods: We analyzed the cost implications in Chile of a switch from the vaccination scheme consisting of a pentavalent vaccine with whole-cell pertussis component (wP) plus IPV/OPV vaccines to a scheme with a hexavalent vaccine with acellular pertussis component (aP) and IPV (Hexaxim®) from a societal perspective. Cost data were collected from a variety of sources including national estimates and previous vaccine studies. All costs were expressed in 2017 prices (US$ 1.00 = $Ch 666.26).

Results: The overall costs associated with the vaccination scheme (4 doses of pentavalent vaccine plus 1 dose IPV and 3 doses OPV) from a societal perspective was estimated to be US$ 12.70 million, of which US$ 8.84 million were associated with the management of adverse events related to wP. In comparison, the cost associated with the 4-dose scheme with a hexavalent vaccine (based upon the PAHO reference price) was US$ 19.76 million. The cost of switching to the hexavalent vaccine would be an additional US$ 6.45 million. Overall, depending on the scenario, the costs of switching to the hexavalent scheme would range from an additional US$ 2.62 million to US$ 6.45 million compared with the current vaccination scheme.

Conclusions: The switch to the hexavalent vaccine schedule in Chile would lead to additional acquisition costs, which would be partially offset by improved logistics, and a reduction in adverse events associated with the current vaccines.

Keywords: Cost; Pediatric; Polio; Vaccination.

MeSH terms

  • Chile
  • Costs and Cost Analysis
  • Diphtheria-Tetanus-Pertussis Vaccine / administration & dosage*
  • Diphtheria-Tetanus-Pertussis Vaccine / economics*
  • Drug Substitution / economics*
  • Haemophilus Vaccines / administration & dosage*
  • Haemophilus Vaccines / economics*
  • Hepatitis B Vaccines / administration & dosage*
  • Hepatitis B Vaccines / economics*
  • Humans
  • Immunization Schedule
  • Infant
  • Poliomyelitis / prevention & control*
  • Poliovirus Vaccine, Inactivated / administration & dosage*
  • Poliovirus Vaccine, Inactivated / economics*
  • Poliovirus Vaccine, Oral / administration & dosage*
  • Poliovirus Vaccine, Oral / economics*
  • Vaccination / economics*
  • Vaccines, Combined / administration & dosage
  • Vaccines, Combined / economics

Substances

  • DTaP-IPV-HB-PRP-T vaccine
  • Diphtheria-Tetanus-Pertussis Vaccine
  • Haemophilus Vaccines
  • Hepatitis B Vaccines
  • Poliovirus Vaccine, Inactivated
  • Poliovirus Vaccine, Oral
  • Vaccines, Combined

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