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"Reverse engineering" a formulary selection algorithm to determine the economic value of pentavalent and hexavalent
E C Sewell1, S H Jacobson, B G Weniger
1Department of Mathematics and Statistics, Southern Illinois University, Edwardsville, IL, USA.
The Pediatric Infectious Disease Journal
|November 13, 2001
Summary
A new algorithm helps determine the optimal pricing for combination vaccines, like pentavalent and hexavalent types, ensuring cost-effectiveness in immunization schedules. This tool aids purchasers in selecting the most economical vaccine options.
Area of Science:
- Health Economics
- Vaccinology
- Operations Research
Background:
- Combination vaccines reduce the number of injections needed for childhood immunization.
- A vaccine selection algorithm was developed using operations research to create cost-effective vaccine formularies.
- The algorithm considers economic factors of competing vaccines to minimize overall immunization costs.
Purpose of the Study:
- To adapt a vaccine selection algorithm to determine the optimal purchase price for hypothetical pentavalent and hexavalent combination vaccines.
- To enable new combination vaccines to be competitively included in lowest-cost formularies.
- To analyze the economic value of future combination vaccines.
Main Methods:
- Integer programming and bisection search methods were used to calculate maximum "inclusion prices" for new combination vaccines.
- The study compared 4 hypothetical combination vaccines against 15 existing formulations.
- Variable costs included preparation (powder, liquid, prefilled syringe) and injection costs ($5-$45), considering payer and societal perspectives.
Main Results:
- Inclusion prices for hypothetical combination vaccines ranged from $9 to $129 per dose, varying with cost assumptions and usage.
- Pentavalent vaccines (e.g., DTPa-HIB-HBV) had inclusion prices of $27-$68, while hexavalent vaccines (DTPa-HIB-HBV-IPV) ranged from $40-$123.
- Higher injection costs ($8+) favored the inclusion of combination vaccines due to savings from fewer injections.
Conclusions:
- Reverse-engineering the vaccine selection algorithm demonstrates the economic value of new combination vaccines.
- This method provides a tool for pricing decisions for new vaccine formulations.
- The study highlights the cost-effectiveness of combination vaccines in reducing overall immunization expenses.
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