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Public health impact and return on investment of the pediatric National Immunization Program in Italy
Marco Barbieri1, Sandra E Talbird2, Justin Carrico2
1York Health Economics Consortium, University of York, York, UK.
Insights
The Italian pediatric National Immunization Program (NIP) offers significant economic benefits, preventing millions of disease cases and saving billions in costs. Continued investment in pediatric immunization is crucial for public health and economic well-being.
Area of Science:
- Public Health
- Health Economics
- Epidemiology
Background:
- Pediatric vaccination programs are essential for disease prevention.
- Assessing the economic impact of immunization programs is vital for resource allocation.
Purpose of the Study:
- To conduct a cost-benefit analysis of the pediatric National Immunization Program (NIP) in Italy.
- To evaluate the benefit-cost ratio (BCR) from both healthcare and societal perspectives.
Main Methods:
- An economic model was developed using decision trees for vaccine-preventable diseases (VPDs).
- The 2020 birth cohort was followed over their lifetime, comparing outcomes with and without immunization.
- Projected metrics included disease cases, life-years, quality-adjusted life-years (QALYs), and costs in 2021 euros.
Main Results:
- The pediatric NIP is projected to prevent 1.8 million VPD cases and 3,330 deaths.
- A societal BCR of 5.6 was estimated (1.7 from a healthcare perspective), rising to 15.6 when QALYs were valued.
- Vaccination costs of €285 million were offset by €1.6 billion in disease cost savings.
Conclusions:
- The Italian pediatric NIP demonstrates substantial economic value through averted morbidity and mortality.
- Continued investment in pediatric immunization programs is strongly supported by these findings.
- The program yields significant public health and economic benefits, underscoring its importance.
Objectives:
We conducted a cost-benefit analysis of the pediatric National Immunization Program (NIP) in Italy.
Methods:
An economic model evaluated the benefit-cost ratio (BCR) of the Italian pediatric NIP, including 10 pathogens for mandatory vaccines and 4 pathogens for recommended vaccines for children aged 0-10 years from the healthcare-sector and societal perspectives. Separate decision trees were used to model each vaccine-preventable disease (VPD). The 2020 birth cohort (n = 420,084) was followed over their lifetime; the model projected and compared discounted disease cases, life-years, quality-adjusted life-years (QALYs), and costs (2021 euros) with and without immunization (based on current and pre - vaccine era disease incidence estimates, respectively).
Results:
The pediatric NIP was estimated to prevent 1.8 million cases of VPDs and 3,330 deaths, resulting in 45,900 fewer life-years lost and 57,000 fewer QALYs lost. Vaccination costs of €285 million were offset by disease cost savings of €1.6 billion, resulting in a BCR of 5.6 from a societal perspective (BCR = 1.7 from a healthcare-sector perspective). When QALYs gained were valued, the BCR increased to 15.6.
Conclusions:
The benefits of the Italian pediatric NIP, including averted disease-related morbidity, mortality, and associated costs, highlight the value of continued investment in pediatric immunization.
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