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Published on: April 4, 2019
Engineering the economic value of two pediatric combination vaccines
Sheldon H Jacobson1, Edward C Sewell, Tamana Karnani
1Department of Mechanical and Industrial Engineering, University of Illinois, Urbana, IL 61801, USA. shj@uiuc.edu
Insights
Operations research analyzed two pentavalent combination vaccines for pediatric immunization. The diphtheria-tetanus-acellular pertussis, hepatitis B, inactivated polio (DTPa-HBV-IPV) vaccine offers good value, while the diphtheria-tetanus-acellular pertussis, Haemophilus influenzae type B, inactivated polio (DTPa-HIB-IPV) may require competitive pricing.
Area of Science:
- Pediatric Vaccinology
- Health Economics
- Operations Research
Background:
- Combination vaccines reduce the number of injections for pediatric immunization schedules.
- Two pentavalent vaccines, DTPa-HBV-IPV and DTPa-HIB-IPV, are evaluated for cost-effectiveness.
- Analyzing vaccine formularies is crucial for optimizing pediatric immunization programs.
Purpose of the Study:
- To apply operations research methodologies to assess the price and value of two pentavalent combination vaccines.
- To compare the cost-effectiveness of DTPa-HBV-IPV and DTPa-HIB-IPV vaccines.
- To develop a methodology for analyzing the impact of combination vaccines on pediatric vaccine formularies.
Main Methods:
- Operations research techniques were employed to analyze vaccine pricing and value.
- Cost-effectiveness was assessed based on administration costs and required doses.
- Individual and head-to-head comparisons of the two pentavalent vaccines were conducted.
Main Results:
- The DTPa-HBV-IPV vaccine demonstrates good value at its current price ($32.75) across various healthcare settings.
- The actual reduction in injections for DTPa-HBV-IPV may be less than manufacturer claims.
- The DTPa-HIB-IPV vaccine, if approved, may need pricing below component costs to compete with DTPa-HBV-IPV.
Conclusions:
- A methodology for evaluating combination vaccines' impact on pediatric formularies has been established.
- DTPa-HBV-IPV presents a cost-effective option for pediatric immunization.
- Market dynamics and pricing strategies are critical for the successful adoption of new combination vaccines like DTPa-HIB-IPV.
Abstract:
Combination vaccines for pediatric immunization have become an effective means to reduce the number of separate injections required to immunize children according to the United States Recommended National Childhood Immunization Schedule. This paper reports the results of using operations research methodologies to analyze the price and value of two pentavalent combination vaccines for pediatric immunization: diphtheria-tetanus-acellular pertussis, hepatitis B, inactivated polio (DTPa-HBV-IPV) and diphtheria-tetanus-acellular pertussis, Haemophilus influenzae type B, inactivated polio (DTPa-HIB-IPV). These two combination vaccines are analyzed both individually and head-to-head, as a function of the cost of administering (or avoiding) an injection and the number of doses of the vaccine required to be in the lowest overall cost vaccine formulary. The main contribution of the paper is to provide a methodology for analyzing the impact of combination vaccines on pediatric vaccine formularies. This analysis shows that the DTPa-HBV-IPV vaccine may provide a good value at the current federally negotiated price of 32.75 dollars for a wide spectrum of health-care environments, though the actual number of injections that it reduces may be fewer than the optimistic numbers claimed by its manufacturer. The analysis also shows that if the DTPa-HIB-IPV vaccine is approved by the Food and Drug Administration (FDA), then under current market prices, it may need to be priced below the sum of its vaccine component prices to favorably compete with the DTPa-HBV-IPV vaccine.
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