Expanding Vaccine Competencies to Community Pharmacists: Modelling Organizational and Economic Impacts of New Human Papilloma Virus (HPV) Vaccines Pathways in France

OBJECTIVES: The French HTA Authority (HAS) recently recommended the extension of vaccine competencies to new actors such as community pharmacists. This research aims to assess the economic and organizational impacts of new HPV-vaccine pathways compared to the GP-only pathway.

METHODS: An innovative Excel® simulation tool was developed to compare the non-expanded vaccine pathway, piloted by general practitioners (GPs), to different scenarios in which pharmacists’ competencies are extended (identification of the target population, prescription and/or injection of the vaccine).

The HAS guidelines have been used to document the criteria defining the organizational impacts such as simplification of the care process or accessibility to care. Economic inputs include cost of vaccine acquisition and administration, and consultation. Model inputs were collected from national data sources and from an ongoing acceptability study, which evaluates the perception of the tested scenarios towards parents of eligible adolescents, GPs and pharmacists.

RESULTS: Compared to the non-expanded pathway, the model will assess the organizational impact of each scenario (or a mix of them) measured in terms of:

• Waiting time to access vaccination
• Number and type of vaccinators
• Patient-Healthcare Professionals (HCPs) numbers of interactions to get a full scheme
• Time dedicated to vaccination per HCP
• Variation in flow of patients per HCP
• Forecasted VCR in 2030 and time required to reach the targeted VCR

Economic impact will be assessed as a cost per patient per scenario, and as an overall cost from the National Health Insurance perspective. Transfer of funding between HCPs for vaccine prescription/administration will also be measured.

CONCLUSIONS: This tool aims to confirm the impact of simplifying vaccination pathway and inform the decision of healthcare authorities. It will also inform the pharmacists on their capacity of taking on this new activity. By increasing the number of vaccinators, an improvement of VCR is expected, which supports the elimination of HPV-induced cancers.