OBJECTIVES : Vaccination is one of the most cost-effective disease prevention measures of all time, however vaccine expenditure is relatively low in many countries. The purpose of this analysis was to evaluate the cost of Russian national immunization program (NIP) for whole population and future budget impact of expanding NIP with 90% varicella, rotavirus vaccination coverage ratio (VCR) in 2021 up to 95% in 2022-2023; human papillomavirus vaccine (vaccination for girls) with 20% in 2021; 30% in 2022; 60% in 2023.

METHODS : Estimation of 5-year (2019-2023) vaccines budget was analyzed by using: federal tender statistics, demographics, VCRs, publicly available vaccine prices, overall healthcare (HC) and drug expenditure data from Ministry of Finance and Obligatory Medical Insurance fund.

RESULTS : Overall cost of Russian NIP in 2019 based on one-year tenders is ₽16,369,808,768 (€221,813,127) which is 0.43% of HC budget in Russia. After NIP modification with rotavirus, varicella and HPV vaccines it will amount ₽37,438,631,850 (€507,298,535), or 0.70% of Russian HC budget. Russian NIP expenditures in 2019 are 2.95% of total drug budget and this share will increase up to 5.37% after NIP modernization by 2023. Cost of NIP per capita in 2019 is ₽111 (€1.51), after NIP modification the cost rises up to ₽255 (€3.46). 79,424,916 doses were procured in 2019 via NIP with 44% of adult and pediatric influenza, 11% of oral polio, 10% of BCG vaccines in units. In monetary terms, procurement of the influenza and pneumococcal vaccines were estimated at 38% and 27% respectively.

CONCLUSIONS : Vaccines still entail a low level of investment in Russia, especially compared with European countries. There is a wide room for Russian NIP modification with rotavirus, varicella and HPV vaccines, it can be considered as a smart investment providing substantial benefit.