2022, Number 2
<< Back Next >>
Revista Cubana de Salud Pública 2022; 48 (2)
Increase in the costs of the National Immunization Program due to the introduction of the pneumococcal vaccine candidate
Chappi EY, Galeano ZL, García FA, Suárez CC, Egües TLI, López AL, Martínez TR
Language: Spanish
References: 23
Page: 1-26
PDF size: 1223.35 Kb.
ABSTRACT
Introduction:
The national industry has developed a vaccine candidate against pneumococcus. Given its possible introduction into the health system, the incremental cost that it would entail must be assessed.
Objective:
To estimate the increase in the costs of the National Immunization Program due to the introduction of the pneumococcal vaccine candidate.
Methods:
Study of cost description from the social perspective for the year 2021. Eight polyclinics in Havana were studied and 38 relatives of infants were interviewed. Institutional cost, out-of-pocket costs and indirect costs were estimated through microcost. The incremental cost was estimated for a three-dose schedule (2p+1), concomitant with other vaccines.
Results:
The total cost for the National Immunization Program in these polyclinics was between 337,000.00 CUP and 513,000.00 CUP, with a cost per dose between 33.11 CUP and 47.30 CUP. 31.6% of families reported transportation expenses from 5.00 CUP to 40.00 CUP. The introduction of the vaccine would represent an increase between 8.43% and 18.99% of the base cost of the National Immunization Program in polyclinics. The cost per dose would be between 34.17 CUP and 47.82 CUP, for an increase of between 0.28 CUP and 1.33 CUP.
Conclusions:
Most of the cost of the National Immunization Program is borne by the State. The application of the Cuban pneumococcal vaccine would only slightly increase the cost per dose.
REFERENCES
López Ambrón L, Egües Torres LI, Pérez Carreras A, Galindo Santana BM, Galindo Sardiña MA, Resik Aguirre S, Tejeda Fuentes A. Experiencia cubana en inmunización, 1962-2016. Rev Panam Salud Pública. 2018 [acceso 14/06/2021];42:e34. Disponible en: http://iris.paho.org/handle/10665.2/349051.
Linares-Pérez N, Wahl B, Rodriguez M, Toraño G, Toledo-Romaní ME. Cuban Pneumococcal Clinical Research, Surveillance and Impact Evaluation Working Group. Burden of pneumococcal disease in children in Cuba before the introduction of a novel pneumococcal conjugate vaccine. J Glob Health Rep. 2019;3:e2019071. DOI: 10.29392/joghr.3.e2019071
Centro de Química Biomolecular. Evaluación de la inmunogenicidad y eficacia del candidato vacunal heptavalente contra neumococos en niños preescolares. FaseII/III (ESCANI). Protocolo de Ensayo Clínico CQB/NEU/14/EC-II/III/03. julio del 2014. La Habana: Centro de Química Biomolecular; 2014 [acceso 15/11/2015]. Disponible en: Disponible en: http://rpcec.sld.cu/ensayos/RPCEC00000182-Sp 3.
Organización Panamericana de la Salud. Introducción e implementación de nuevas vacunas: guía práctica. Publicación Científica y Técnica 632. Washington, DC.: OPS; 2009 [acceso 08/04/2020] Disponible en: https://iris.paho.org/handle/10665.2/491794.
Mvundura M, Duy Kien V, Tuyet Nga N, Robertson J, Van Cuong N, Thanh Tung H, et al. How much does it cost to get a dose of vaccine to the service delivery location? Empirical evidence from Vietnam's Expanded Program on Immunization. Vaccine. 2014 32(7):834-8. DOI: 10.1016/j.vaccine.2013.12.029
Vaughan K, Ozaltin A, Mallow M, Moi F, Wilkason C, Stone J, Brenzel L. The costs of delivering vaccines in low- and middle-income countries: Findings from a systematic review. Vaccine. 2019;100034. DOI: 10.1016/j.jvacx.2019.100034
Brenzel L. What have we learned on costs and financing of routine immunization from the comprehensive multi-year plans in GAVI eligible countries? Vaccine. 2015;33(Suppl 1):A93-8. DOI: 10.1016/j.vaccine.2014.12.076Get
Menzies NA, Suharlim C, Geng F, Ward ZJ, Brenzel L, Resch SC. The cost determinants of routine infant immunization services: a meta-regression analysis of six country studies. BMC Medicine. 2017 [acceso 08/04/2020];15:178. Disponible en: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0942-18.
Vaughan K, Clarke-Deelder E, Tani K, Lyimo D, Mphuru A, Manzi F, et al. Immunization costs, from evidence to policy: Findings from a nationally representative costing study and policy translation effort in Tanzania. Vaccine. 2020;38:7659-67. DOI: 10.1016/j.vaccine.2020.10.004
Portnoy A, Ozawa S, Grewal S, Norman B A, Rajgopal J, Gorham K M, Haidari L A, Brown S T, Lee B Y. Costs of vaccine programs across 94 low- and middle-income countries. Vaccine. 2015;33S:A99-A108. DOI: 10.1016/j.vaccine.2014.12.037
Schütte C, Chansa C, Marinda E, Guthrie TA, Banda S, Nombewu Z, et al. Cost analysis of routine immunisation in Zambia. Vaccine. 2015;33(Suppl 1):A47-52. DOI: 10.1016/j.vaccine.2014.12.040
Bess Janusz C, Castañeda-Orjuela C, Molina Aguilera IB, Felix Garcia AG, Mendoza L, Díaz IY. Examining the cost of delivering routine immunization in Honduras. Vaccine. 2015;33(1):A53-A59. DOI: 10.1016/j.vaccine.2015.01.016
Goguadze K, Chikovani I, Gaberi C, Maceira D, Uchaneishvili, Chkhaidze M, et al. Costs of routine immunization 2015 services in Moldova: Findings of a facility-based costing study. Vaccine. 2020;33(Supl.):A60-A65. DOI: 10.1016/j.vaccine.2014.12.034
Walker D, Mosqueira NR, Penny ME, Lanata CF, Clark AD, Sanderson CF, et al. Variation in the costs of delivering routine immunization services in Peru. Bull World Health Organ. 2004 [acceso 05/05/2020];82(9):676-82. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622978/14.
Bishai D, McQuestion M, Chaudhry R, Wigton A. The Costs Of Scaling Up Vaccination In The World's Poorest Countries. Health Affairs. 2006;25:348-356. DOI: 10.1377/hlthaff.25.2.348
Chatterjee S, Ghosh A, Das P, Menzies NA, Laxminarayan R. Determinants of cost of routine immunization programme in India. Vaccine. 2018;36:3836-41. DOI: 10.1016/j.vaccine.2018.05.006
Portnoy A, Vaughan K, Clarke-Deelder E, Suharlim C, Resch SC, Brenzel L, et al. Producing Standardized Country-Level Immunization Delivery Unit Cost Estimates. Pharmaco Economics. 2020;38:995-1005. DOI: 10.1007/s40273-020-00930-6
Village Reach. Comparison of costs incurred in dedicated and diffused vaccine logistics systems: cost-effectiveness of vaccine logistics in Cabo Delgado and Niassa Provinces, Mozambique. Seattle, Estados Unidos: Village Reach; 2009 [acceso 22/05/2020]. Disponible en: Disponible en: http://www.villagereach.org/wp-content/uploads/2010/10/091009-VillageReach-Cost-Study-Report.pdf 18.
Hutton G, Tediosi F. The costs of introducing a malaria vaccine through the Expanded Program on Immunization in Tanzania. Am J Trop Med Hyg. 2006 [acceso 05/06/2020];75(Suppl. 2):119-30. Disponible en: https://pubmed.ncbi.nlm.nih.gov/16931823/19.
Assi TM, Brown ST, Kone S, Norman BA, Djibo A, Connor DL, et al. Removing the regional level from the Niger vaccine supply chain. Vaccine. 2013;31(26):2828-34. DOI: 10.1016/j.vaccine.2013.04.011
Menzies NA, Suharlim C, Geng F, Ward ZJ, Brenzel L, Resch SC. The cost determinants of routine infant immunization services: a meta-regression analysis of six country studies. BMC Med. 2017;15(1):178. DOI: 10.1186/s12916-017-0942-1
Sinha A, Levine O, Knoll MD, Muhib F, Lieu TA. Cost-effectiveness of pneumococcal conjugate vaccination in the prevention of child mortality: an international economic analysis. Lancet. 2007;369:389-96. DOI: 10.1016/S0140-6736(07)60195-0
Pérez-Valbuena GJ, Silva-Ureña A. Una mirada a los gastos de bolsillo en salud para Colombia. Publicación sobre economía regional del Banco de la República-Sucursal Cartagena. Econ Papers. 2015 [acceso 22/05/2020]. Disponible en: http://econpapers.repec.org/paper/col000102/012780.htm23.