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Measuring the cost of a pediatric vaccine administration in the UK
S Mokiou1, B Standaert2, X Li2
1Merck UK & ROI, Merck Serono Ltd, Feltham, Middlesex, UK.
Insights
This study accurately calculated the time and cost for vaccine administration in UK pediatric practices. The total cost per vaccine visit, including all activities, was £11.9.
Area of Science:
- Health economics
- Vaccinology
- Public health
Background:
- Vaccine administration costs are often underestimated due to incomplete reporting of pre-vaccination and on-the-day activities.
- Accurate cost-effectiveness analysis is crucial for healthcare resource allocation and policy-making.
Purpose of the Study:
- To accurately determine the total time and cost associated with vaccine dose administration in UK general practitioner (GP) practices.
- To provide a comprehensive cost analysis that includes all activities from preparation to post-vaccination.
Main Methods:
- A field study was conducted across 6 UK GP sites over 4 months (April-June 2015).
- Workflow mapping and interviews were used to identify pre-vaccination activities and estimate their costs.
- Time & Motion (T&M) methodology was employed for a prospective, non-interventional study to measure on-the-day vaccination activities, including consumables and guardian time.
- Data were analyzed using a random intercept model to account for site-specific variations.
Main Results:
- 123 T&M observations were collected, stratified by vaccination visit within the first year of life.
- The total cost per vaccine visit, including supply costs and pre-vaccination activities, averaged £11.9 (range: £8.6-£17.0).
- The time per vaccine dose administered was 7.1 minutes (range: 5.7-9.2), with an associated cost of £4.3 (range: £3.1-£6.2).
Conclusions:
- The study provides an accurate reflection of the resources required for vaccine administration in UK pediatric settings.
- The calculated costs align with the current National Health Services (NHS) fee schedule, validating the methodology.
- This detailed cost analysis can inform healthcare budgeting and improve the efficiency of vaccination programs.
Abstract:
The administration of a vaccine dose involves a series of activities prior to and on the day of vaccine delivery. Total vaccination cost should include the cost of each activity, which is often not done or poorly reported. To calculate those costs a field study was performed in 6 United Kingdom (UK) sites (General Practitioner (GP) practices) during a 4-month period (April-June 2015). First, a workflow map of all the relevant vaccine-related activities per site was obtained through interviews. Second, time estimates for activities happening prior to the vaccination day were obtained through interviews and associated costs were calculated. A prospective, non-interventional study using Time & Motion (T&M) methodology was used to measure time for activities happening on the day of vaccination. Consumables, wastage, and guardian time were also collected. Third, the time for each task and for all tasks combined during the T&M study was analyzed using a random intercept model to account for site effect. Hundred and twenty-three T&M observations with approximately 20 per site were collected and were equally stratified by vaccination visit during the first year of a baby's life. Total cost per visit was £11.9 (site range: £8.6-£17.0) when supply cost and time for activities prior to the vaccination day were included. Time per dose administrated was 7.1 min (site range: 5.7-9.2) and the associated cost was £4.3 (site range: £3.1-£6.2). The study demonstrates an accurate reflection of the time and cost involved in a vaccine dose administration in a pediatric setting in the UK. The amount measured is consistent with the current National Health Services fee schedule.
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