Economics of vaccination
Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001
Fangjun Zhou, PhD; Jeanne Santoli, MD, MPH; Mark L. Messonnier, PhD; Hussain R. Yusuf, MBBS, MPH; Abigail Shefer, MD; Susan Y. Chu, PhD, MSPH; Lance Rodewald, MD; Rafael Harpaz, MD, MPH
Arch Pediatr Adolesc Med. 2005;159:1136-1144.
Objective
To evaluate the economic impact of the routine US childhood immunization schedule: diphtheria and tetanus toxoids and acellular pertussis; tetanus and diphtheria toxoids; Haemophilus influenzae type b conjugate; inactivated poliovirus; measles, mumps, and rubella; hepatitis B; and varicella vaccines.
Design
Decision tree-based analysis was conducted using population-based vaccination coverage, published vaccine efficacies, historical data on disease incidence before vaccination, and disease incidence reported for 1995-2001. Costs were estimated using the direct cost and societal (direct and indirect costs) perspectives. Program costs included vaccine, administration, vaccine-associated adverse events, and parent travel and time lost. All costs were inflated to 2001 US dollars, and all costs and benefits in the future were discounted at a 3% annual rate.
Participants
A hypothetical 2001 US birth cohort of 3 803 295 infants was followed up from birth through death.
Main Outcome Measures
Net present value (net savings) and benefit-cost ratios of routine immunization.
Results
Routine childhood immunization with the 7 vaccines was cost saving from the direct cost and societal perspectives, with net savings of $9.9 billion and $43.3 billion, respectively. Without routine vaccination, direct and societal costs of diphtheria, tetanus, pertussis, H influenzae type b, poliomyelitis, measles, mumps, rubella, congenital rubella syndrome, hepatitis B, and varicella would be $12.3 billion and $46.6 billion, respectively. Direct and societal costs for the vaccination program were an estimated $2.3 billion and $2.8 billion, respectively. Direct and societal benefit-cost ratios for routine childhood vaccination were 5.3 and 16.5, respectively.
Conclusion
Regardless of the perspective, the current routine childhood immunization schedule results in substantial cost savings.
Author Affiliations:
National Immunization Program, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Ga. Dr Yusuf is now with UNICEF, New Delhi, India.
Fangjun Zhou, PhD; Jeanne Santoli, MD, MPH; Mark L. Messonnier, PhD; Hussain R. Yusuf, MBBS, MPH; Abigail Shefer, MD; Susan Y. Chu, PhD, MSPH; Lance Rodewald, MD; Rafael Harpaz, MD, MPH
Arch Pediatr Adolesc Med. 2005;159:1136-1144.
Objective
To evaluate the economic impact of the routine US childhood immunization schedule: diphtheria and tetanus toxoids and acellular pertussis; tetanus and diphtheria toxoids; Haemophilus influenzae type b conjugate; inactivated poliovirus; measles, mumps, and rubella; hepatitis B; and varicella vaccines.
Design
Decision tree-based analysis was conducted using population-based vaccination coverage, published vaccine efficacies, historical data on disease incidence before vaccination, and disease incidence reported for 1995-2001. Costs were estimated using the direct cost and societal (direct and indirect costs) perspectives. Program costs included vaccine, administration, vaccine-associated adverse events, and parent travel and time lost. All costs were inflated to 2001 US dollars, and all costs and benefits in the future were discounted at a 3% annual rate.
Participants
A hypothetical 2001 US birth cohort of 3 803 295 infants was followed up from birth through death.
Main Outcome Measures
Net present value (net savings) and benefit-cost ratios of routine immunization.
Results
Routine childhood immunization with the 7 vaccines was cost saving from the direct cost and societal perspectives, with net savings of $9.9 billion and $43.3 billion, respectively. Without routine vaccination, direct and societal costs of diphtheria, tetanus, pertussis, H influenzae type b, poliomyelitis, measles, mumps, rubella, congenital rubella syndrome, hepatitis B, and varicella would be $12.3 billion and $46.6 billion, respectively. Direct and societal costs for the vaccination program were an estimated $2.3 billion and $2.8 billion, respectively. Direct and societal benefit-cost ratios for routine childhood vaccination were 5.3 and 16.5, respectively.
Conclusion
Regardless of the perspective, the current routine childhood immunization schedule results in substantial cost savings.
Author Affiliations:
National Immunization Program, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services, Atlanta, Ga. Dr Yusuf is now with UNICEF, New Delhi, India.
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