Cost-Minimization Analysis on Vaccination Strategies of DTaP-Containing Combination Vaccines: Evidence from China

OBJECTIVES: Combination vaccine is a highly efficient way of vaccination. We aim to estimate the cost impacts of multiple administration strategies of the two kinds of combination vaccines -DTaP/Hib and DTaP-IPV/Hib, from the national and provincial dimensions.

METHODS: Three vaccination strategies were evaluated: DTaP+ IPV+ bOPV+ Hib (scheme 1), DTaP/Hib+ IPV+ bOPV (scheme 2), and DTaP-IPV/Hib (scheme 3). A cost-minimization analysis (CMA) was performed from caregivers’, health service providers’, and societal perspectives, and from the national and provincial dimensions. Direct medical, direct nonmedical, and indirect social costs were taken into account in the 3 schemes. Costs were obtained from multiple sources (second data,and a questionnaire-based survey in Hangzhou, Zhejiang Province). A univariate deterministic sensitivity analysis (DSA) was conducted.

RESULTS: Totally, the cost per child of scheme 1,2,3 was RMB 5030.83 vs. RMB 4715.24 vs. RMB 4106.19 from societal perspective. The societal cost of 2022 birth cohort were RMB 48,094.76 million vs. RMB 45,077.71million vs. RMB 39,255.18 million. At the provincial level, the scheme 3 was the least from societal perspective in 26 provinces, except Gansu, Guangxi, Guizhou, Heilongjiang and Jilin Province.

CONCLUSIONS: The results of this study recommended immunization strategies containing DTaP/Hib and especially DTaP-IPV/Hib, for the cost saving from a societal perspective compared with the scheme containing DTaP, bOPV, IPV and Hib.