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Analyzing the economic value of the hepatitis B--Haemophilus influenzae type B combination vaccine by reverse
Sheldon H Jacobson1, Tamana Karnani, Edward C Sewell
1Department of Mechanical and Industrial Engineering, 1206 West Green Street (MC-244), University of Illinois, Urbana, IL 61801, USA. karnani@uiuc.edu
Insights
Combination vaccines, like the hepatitis B-Haemophilus influenzae type B vaccine, offer economic value by reducing injection costs. Their cost-effectiveness increases with higher administration expenses, making them preferable to single-dose vaccines.
Area of Science:
- Pediatric Immunization
- Health Economics
- Vaccine Policy
Background:
- Combination vaccines reduce the number of injections needed for pediatric immunization.
- Evaluating the economic value of combination vaccines is crucial for healthcare providers and payers.
- The hepatitis B-Haemophilus influenzae type B (HepB-Hib) combination vaccine is under federal contract in the US.
Purpose of the Study:
- To reverse engineer a vaccine selection algorithm to assess the economic value of the HepB-Hib combination vaccine.
- To analyze the trade-off between vaccine administration costs and vaccine pricing for formulary placement.
- To determine the economic value of the HepB-Hib combination vaccine based on its US federal contract price.
Main Methods:
- Reverse engineering of a vaccine selection algorithm.
- Economic analysis of vaccine administration costs versus vaccine price.
- Formulary cost analysis considering different dosing requirements and the perinatal hepatitis B dose.
Main Results:
- The HepB-Hib combination vaccine offers good economic value at a US federal contract price (as of August 9, 2002).
- The break-even injection administration cost for economic value is US$4.02 or US$5.01, depending on dosing and perinatal dose administration.
- The economic value of the combination vaccine improves relative to monovalent vaccines as injection costs rise.
Conclusions:
- The HepB-Hib combination vaccine presents a favorable economic value proposition for US healthcare providers and payers.
- The cost-effectiveness of combination vaccines is sensitive to injection administration costs.
- Increased costs for administering single-antigen vaccines enhance the economic advantage of combination vaccines.
Abstract:
Combination vaccines for pediatric immunization provide a means to reduce the number of separate injections required to immunize children. This paper reports the results of reverse engineering a vaccine selection algorithm to evaluate the economic value of a hepatitis B-Haemophilus influenzae type B combination vaccine that is currently under federal contract in the United States. This analysis captures the tradeoff between the cost assigned to administering an injection and the price of the vaccine that earns it a place in the lowest overall cost formulary. Given the current United States federally negotiated price for this combination vaccine (as of 9 August 2002), it provides a good economic value for those health-care providers or payers who value the cost associated with administering an injection to be at least US$ 4.02 or 5.01. These two values are a function of the number of doses of the combination vaccine required to be in the lowest overall cost formulary and whether the perinatal hepatitis B dose is administered. Moreover, as the cost of an injection increases, the combination vaccine provides a better value than monovalent vaccines.
