OBJECTIVES

Simplification in vaccine preparation save time and reduce potential immunization errors. The aim of this study is to perform a cost-minimization analysis and to assess the opportunity cost of fully-liquid vaccine versus non-fully liquid vaccines that need reconstitution, for hexavalent (DTaP-IPV-HB-Hib) and MenAWYC vaccines.

METHODS

A minimization-cost model based on the time spent in the preparation and administration of the vaccines and the risk of preparation errors was developed. Persons eligible for receiving vaccination with hexavalent and/or MenACWY were defined as the target population, and the number of vaccines administrated in one year was calculated. Results are expressed in vaccine doses administrated per 100.000 inhabitants. Times spent in the vaccination visit were obtained from a ‘time-and-motion’ (T&M) study. The percentage of preparation errors was obtained from EUDRAVIGILANCE database. Unit cost of hexavalent and MenACWY vaccines and nurse salary costs were obtained from public data of the Spanish ministry of health. Deterministic sensitivity analysis (scenarios and univariate) were developed. A multidisciplinary panel of experts was consulted to assess the opportunity cost of the utilization of fully-liquid hexavalent and MenACWY vaccines.

RESULTS

The use of fully-liquid vaccines would save 62.92 healthcare-hours in one year per 100.000 inhabitants (41.68 and 21.23 hours with hexavalent and MenAWYC vaccines, respectively). Economically, this time saved would translate into € 2.220,5 per 100.000 inhabitants saved for the Spanish healthcare system. The deterministic analysis performed confirmed the robustness of the base-case results. The experts consulted concluded that improving the communication with the parents would be the main action that could be carried out with the extra-time obtained by using fully-liquid vaccines.

CONCLUSIONS :

The use of fully-liquid hexavalent and MenAWYC vaccines instead of non-fully liquid presentation, would provide savings in health professionals' time that could be reinvested in other tasks or improving the quality of the visit.