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Cost benefit analysis of Haemophilus influenzae type b vaccination programme in Israel
G M Ginsberg1, I Kassis, R Dagan
1Department of Data Analysis, Ministry of Health, Jerusalem, Israel.
Insights
Implementing a nationwide Haemophilus influenzae type b (Hib) vaccination program in Israel is cost-effective. The societal benefits of Hib prevention programs significantly outweigh the costs, making it a worthwhile public health investment.
Area of Science:
- Public Health
- Vaccinology
- Health Economics
Background:
- Haemophilus influenzae type b (Hib) conjugate vaccines are now available.
- Hib infections pose a significant public health challenge, particularly in children.
- Previous vaccination programs have shown success in reducing Hib incidence.
Purpose of the Study:
- To evaluate the cost-effectiveness of four-dose versus three-dose Hib prevention programs in Israel.
- To analyze the economic benefits and costs of nationwide Hib vaccination for all newborns.
Main Methods:
- Cost-benefit analysis of Hib vaccination programs.
- Modeling of Hib disease reduction under different vaccination scenarios.
- Calculation of benefit-to-cost ratios considering direct and indirect economic impacts.
Main Results:
- A four-dose Hib vaccination program is projected to reduce annual childhood Hib cases from 184.2 to 31.3.
- The benefit-to-cost ratio for health services alone is 0.29:1, but rises to 1.45:1 when including indirect benefits.
- Break-even vaccine costs are $2.24 per dose for health services and $11.21 per dose when all societal benefits are considered.
Conclusions:
- Nationwide Hib vaccination programs in Israel are recommended as societal monetary benefits exceed costs.
- A potential implementation barrier exists due to program costs exceeding direct health service benefits.
- The study highlights the substantial economic advantages of comprehensive Hib prevention strategies.
Study Objective:
The recent availability of Haemophilus influenzae type b (HIB) conjugate vaccines prompted an examination of the costs and benefits of four and three dose HIB prevention programmes targeting all newborns in Israel.
Measurements And Main Results:
A four dose programme would reduce the number of childhood (aged 0-13) HIB cases from 184.2 to 31.3 per year, yielding a benefit ($1.03 million) to cost ($3.55 million) ratio of just 0.29/l for health services only, based on a vaccine price of $7.74 per dose. When benefits resulting from a reduction in mild handicaps and severe neurological sequelae are included, the benefit ($4.48 million) to cost ratio rises to 1.26/l and it reaches 1.45/l when the $0.66 million indirect benefits of reduced work absences and mortality are also included. Break even vaccine costs are $2.24 when health service benefits only are considered and $11.21 when all the benefits are included.
Conclusion:
In the absence of other projects with higher benefit to cost ratios, Israel should start to provide a nationwide HIB vaccination programme since the monetary benefits to society of such a programme will exceed the costs to society. A barrier to implementation may occur, however, because the costs of the programme exceed the benefits to the health services alone.