FISCAL VALUE OF IMMUNISATION PROGRAMS: WORLDWIDE EVIDENCE SUPPORTING GOVERNMENT INVESTMENT DECISIONS
Author(s)
Laigle Valérie, PharmD1, Alain Dutilleul, MSc2, Mikaela Dock, PharmD2, Sreenu Lavudiya, MPharm3, Antonio Robles, PhD1.
1Global Health Economics & Value Assesment, Sanofi Vaccines, Lyon, France, 2Global Vaccines Public Affairs, Sanofi Vaccines, Lyon, France, 3Global Health Economics & Value Assesment, Sanofi Vaccines, Hyderabad, India.
1Global Health Economics & Value Assesment, Sanofi Vaccines, Lyon, France, 2Global Vaccines Public Affairs, Sanofi Vaccines, Lyon, France, 3Global Health Economics & Value Assesment, Sanofi Vaccines, Hyderabad, India.
OBJECTIVES: Governments worldwide require quantitative evidence to defend, and plausibly increase, public investment in immunisation programmes amid competing budget priorities. Fiscal Health Modelling captures broader government returns through tax revenue gains, productivity preservation, and reduced social transfers. This study synthesises the available evidence on fiscal returns from immunisation programmes across countries to demonstrate their value as strategic government investments supporting both population health and long-term fiscal sustainability.
METHODS: Fiscal outcomes from immunisation programmes were extracted and synthesised from a targeted literature review of 38 studies across 26 countries (2010-2026). Key metrics included fiscal benefit-cost ratios (fBCR), net fiscal benefits, and tax revenue gains.
RESULTS: General vaccination frameworks demonstrated benefit-cost ratios ranging from 1 in France to 3.9 for life-course vaccination in Colombia over 60 years. HPV vaccination achieved fiscal benefit-cost ratios ranging from 1.2 to 3.8 across four countries including Germany, Portugal, Switzerland and Indonesia, with Indonesia generating a net present value of I$2.0 billion. Rotavirus vaccination generated tax revenue gains ranging from EUR 14.5 million to USD 84 million across five countries including Turkey, Netherlands, Ghana, Vietnam and Egypt, with Ghana demonstrating a return on investment of USD 2.9 per USD 1 invested. COVID-19 vaccination achieved fiscal benefit-cost ratios ranging from 1.32 to 1.54 across UK population groups, whilst consumption tax gains ranged from 2.2% to 10.8% across 12 EU countries. Influenza vaccination for healthcare workers in Italy generated fiscal revenues ranging from EUR 327,000 to EUR 388,000. Paediatric immunisation programmes achieved fiscal benefit-cost ratios ranging from 2.2 to 17.8 across countries including Belgium, Greece, Colombia and the United States.
CONCLUSIONS: Worldwide evidence indicates that immunisation programmes may generate positive fiscal returns across diverse economic settings, vaccine types and populations, supporting their positioning as strategic government investments that enhance both population health and fiscal sustainability.
METHODS: Fiscal outcomes from immunisation programmes were extracted and synthesised from a targeted literature review of 38 studies across 26 countries (2010-2026). Key metrics included fiscal benefit-cost ratios (fBCR), net fiscal benefits, and tax revenue gains.
RESULTS: General vaccination frameworks demonstrated benefit-cost ratios ranging from 1 in France to 3.9 for life-course vaccination in Colombia over 60 years. HPV vaccination achieved fiscal benefit-cost ratios ranging from 1.2 to 3.8 across four countries including Germany, Portugal, Switzerland and Indonesia, with Indonesia generating a net present value of I$2.0 billion. Rotavirus vaccination generated tax revenue gains ranging from EUR 14.5 million to USD 84 million across five countries including Turkey, Netherlands, Ghana, Vietnam and Egypt, with Ghana demonstrating a return on investment of USD 2.9 per USD 1 invested. COVID-19 vaccination achieved fiscal benefit-cost ratios ranging from 1.32 to 1.54 across UK population groups, whilst consumption tax gains ranged from 2.2% to 10.8% across 12 EU countries. Influenza vaccination for healthcare workers in Italy generated fiscal revenues ranging from EUR 327,000 to EUR 388,000. Paediatric immunisation programmes achieved fiscal benefit-cost ratios ranging from 2.2 to 17.8 across countries including Belgium, Greece, Colombia and the United States.
CONCLUSIONS: Worldwide evidence indicates that immunisation programmes may generate positive fiscal returns across diverse economic settings, vaccine types and populations, supporting their positioning as strategic government investments that enhance both population health and fiscal sustainability.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH260
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
Vaccines