OBJECTIVE: To evaluate the cost/benefit of different vaccination strategies related to chickenpox vaccine. METHODS: The direct economic cost and indirect economic cost caused by chickenpox were obtained through questionnaire survey. The epidemic characteristics of chickenpox in Zhejiang province were studied by literature review. Dynamic model was set up by Matlab software based on the parameters of chickenpox, to predict the incidence trends of chickenpox with different immunization strategies (no vaccination, 1-dose vaccination, 2-dose vaccination) in future 40 years (2017-2056). A cost-benefit analysis was conducted, and the sensitivities of the main parameters were analyzed. RESULTS: Through the questionnaire survey of 105 cases, the direct and indirect economic cost per case was 506.84 Yuan and 1045.39 Yuan respectively, with the total of 1552.23 Yuan. During the prediction period (40 years), there would be 7.0908 million cases in strategy 2, which was 59.71% less than strategy 1 (17.5989 million cases). Total vaccination costs in strategy 2 were 2.366 billion Yuan, with a total economic gain of 33.741 billion Yuan and benefit/cost ratio (BCR) of 14.26:1. If strategy 3 was adopted, 2.7249 million chickenpox cases would occur, with a decrease of 84.52% compared with strategy 1. Total vaccination costs in strategy 3 was 4.495 billion Yuan, with a total economic gain of 44.309 billion Yuan and BCR of 9.86:1. Analysis showed that the vaccine price was the most sensitive variable, followed by the incidence of chickenpox in the absence of vaccine. CONCLUSIONS In Zhejiang province, one-dose strategy and two-dose strategy were both cost effective. It is suggested that the chickenpox vaccination should be included in the immunization program in Zhejiang province.
Chickenpox ; prevention & control ; Chickenpox Vaccine ; Cost-Benefit Analysis ; Humans ; Immunization Programs ; economics ; methods ; Vaccination ; economics

Meningococcal meningitis is an acute, severe respiratory infectious disease caused by Neisseria meningitidis. Immunization with meningococcal vaccine is the most effective measure to control and prevent transmission of meningococcal meningitis. Meningococcal vaccines in the Chinese market include meningococcal polysaccharide vaccine, meningococcal polysaccharide conjugate vaccine, and a combined vaccine containing meningococcal polysaccharide conjugate vaccine. This article reviews research progress on the efficacy, safety, and cost-effectiveness of meningococcal vaccines, particularly in the Chinese market, to support appropriate use of the various meningococcal vaccines for preventing meningococcal meningitis.
Cost-Benefit Analysis ; Humans ; Immunization/economics* ; Meningitis, Meningococcal/prevention & control* ; Meningococcal Vaccines/immunology* ; Vaccination/economics* ; Vaccines, Conjugate/immunology*

Cervical carcinoma has brought huge burden on patients, especially in developing countries. Preventive vaccines could effectively reduce the incidence of cervical carcinoma. The high prices were one of the most difficult problem in introducing the vaccine in developing countries, so the cost-effectiveness and health financing of the vaccines should be carefully studied before incorporated into the national immunization program. Thus, researchers used mathematical models to predict the effects of HPV vaccines and to study the cost- effectiveness. In order to understand the current situation on the cost-effectiveness of HPV vaccines in the developing countries, a systematic searching of literature from PubMed, Elsevier Science Direct, Medline, ProQuest, CNKI and Wangfang Data was performed, this study aims to conduct a systematic review from aspects of project source, first author, research areas, research perspectives, prevention strategies, vaccine characteristics, cost-effectiveness.
Cost-Benefit Analysis ; Developing Countries ; Female ; Humans ; Immunization Programs ; Incidence ; Models, Theoretical ; Papillomavirus Infections ; economics ; prevention & control ; Papillomavirus Vaccines ; economics ; Uterine Cervical Neoplasms ; economics ; prevention & control

OBJECTIVETo assess the economic implications of an annual vaccination strategy against influenza among people who were on a social-health program.

METHODSA retrospective cohort study was conducted. 1900 persons who had received the influenza vaccine were served as vaccine group, while 1049 persons who did not receive the vaccine were served as controls. Cluster random sampling method was used. Both of these two groups came from Donfang Company in which there were 12,109 employers in total and all of them joined the social health insurance program. The survey was carried out when the influenza vaccine was given one year ago.

RESULTSThe rates of vaccine group and control group for respiratory system diseases and cardiovascular diseases who were hospitalized, were 0.51%, 2.47% and 1.64%, 5.62% which showed 68.90% and 56.05% decrease, when compared with the control group. The crude inpatient rate among vaccinees and control group after receiving the vaccination for three and four month were 0.62%, 0.80% and 0.28%, 1.00% respectively. The inpatient rate of oldest-age group decreased by 53.59%, compared with control group. The cost-benefit ratio generated by the use of influenza vaccine in reducing the hospitalization rate was 6.48:1 for Social Health Insurants in Xi'an city.

CONCLUSIONThe Strategy to vaccinate the social-health-insured residents on influenza in Xi'an city had gained better economic benefits in reducing the hospitalization rate of respiratory system diseases and cardiovascular diseases for mild and old-aged persons.

Adult ; China ; Cost-Benefit Analysis ; methods ; Female ; Hospitalization ; economics ; statistics & numerical data ; Humans ; Immunization Programs ; economics ; Influenza Vaccines ; therapeutic use ; Influenza, Human ; economics ; prevention & control ; Insurance, Health ; economics ; Male ; Middle Aged ; Social Security ; economics

An economic evaluation of Haemophilus influenzae type b (Hib) immunization was conducted to examine whether Hib immunization should be included in the Korea's national immunization program. The costs and benefits included direct and indirect values and an estimation of the economic efficiency. We determined that a universal Hib immunization program in Korea would prevent 17 deaths and 280 invasive Hib cases. When we assumed the one Hib immunization cost as 26,000 won, the national Hib immunization would cost 34.6 billion won. Costs for various Hib diseases were estimated at 26.8 billion won (11.8 billion won from direct costs and 14.9 billion won from indirect costs). A benefit-cost ratio of 0.77 showed that the economic efficiency of the integration of Hib immunization in Korea is low because of the low incidence rate of Hib disease and high price of vaccine. However, if the Hib immunization cost decrease to less than 20,000 won, a benefit-cost ratio increase to 1.0 and above, integrating Hib immunization into the national immunization program with economic efficiency can be considered.
Child ; Child, Preschool ; Cost of Illness ; Cost-Benefit Analysis ; Decision Support Techniques ; Haemophilus Infections/*economics/*prevention & control ; Haemophilus Vaccines/*economics/*therapeutic use ; Haemophilus influenzae type b/*metabolism ; Humans ; Immunization/*economics ; Immunization Schedule ; Infant ; Korea ; Models, Economic ; State Medicine

The current EPI (Expanded Programme on Immunization) vaccines do not specifically target the organisms that lead to the two main causes of death in children - pneumonia and diarrhoea. This implies that the EPI vaccines will have only a modest effect on total child mortality. However, recent evidence suggests that measles and BCG vaccines dramatically reduce child mortality through nonspecific effects - that is, they reduce mortality from many causes, not just measles and tuberculosis. The combination of BCG at birth and measles vaccine at 6 months probably reduces total mortality to about one-third of its previous level. This means that immunization must now have the very highest priority. If we could improve immunization in Papua New Guinea so that all children received BCG, measles, diphtheria-pertussis-tetanus and polio vaccines, we would reduce child mortality from 120 to approximately 52 per 1000 livebirths - a truly spectacular reduction. The old polysaccharide pneumococcal vaccine is safe and effective and bulk purchases are likely to cost US$1 a dose or less. Further studies are needed of the effects of pneumococcal vaccine. Immunization of mothers and babies might reduce child mortality by 20%, at a cost of only US$83 per life saved. The available evidence suggests that one dose of pneumococcal vaccine given to every Papua New Guinean over 5 years of age every 5 years would save approximately 6600 lives a year and the vaccine would cost only US$121 per life saved. It will not be easy to achieve high immunization rates throughout Papua New Guinea. Vaccines will have to be given the highest possible priority, with curative medical services secondary to immunization. Health workers, government, the general population and overseas donors will have to be convinced of the very great benefits that will come from effective immunization. A sustained education campaign will be needed in addition to the establishment of an effective delivery system. The time has come for a radical shift in emphasis in Papua New Guinea: from hospitalization to immunization.
BCG Vaccine - therapeutic use ; Bacterial Vaccines - therapeutic use ; Immunization - economics ; Infant Mortality ; Papua New Guinea ; Pneumococcal Vaccines - therapeutic use

OBJECTIVETo study the cost-effectiveness, benefit and utility of infant hepatitis B vaccination in Shanghai from 1992 to 2001.

METHODSTo calculate the cost of hepatitis B vaccination by cost analysis method. Both the numbers of persons with HBsAg positive and patient with hepatitis B, cirrhosis and liver cancer decreased as the index of direct effect. To study the sick-time and the cost of treating hepatitis B, cirrhosis and liver cancer patients, a face to face questionnaire was used and quasi method was adopted to understand the effect of cure and the course of hepatitis B. The cost benefit analysis method was also used to calculate the cost benefit of HBV vaccine. The disability adjusted life years (DALY) was regarded as an index of utility to measure the disease burden.

RESULTSInput of 501,129.49 Yuan might have the result of reducing one liver cancer patient, ten cirrhosis patients, one hundred chronic hepatitis B patients and one thousand HBsAg positive people. The cost of hepatitis B vaccination was 0.24 hundred million Yuan during the past ten years in Shanghai, which had obtained the total benefit value of 41.22 hundred million Yuan, with a cost benefit ratio of 1:172 Yuan. It was estimated that the total disease burden of hepatitis B, cirrhosis and liver cancer patients was 59,762.55 DALY in order to reduce one DALY loss cost of 402.50 Yuan.

CONCLUSIONHBV vaccine inoculation in infants seemed to be a low-cost input and high-effect output strategy.

Adult ; Cost-Benefit Analysis ; Female ; Hepatitis B ; complications ; economics ; prevention & control ; Hepatitis B Vaccines ; economics ; therapeutic use ; Humans ; Immunization Programs ; economics ; Infant, Newborn ; Liver Cirrhosis ; economics ; etiology ; Liver Neoplasms ; economics ; etiology ; Male ; Markov Chains ; National Health Programs ; Quality of Life ; Surveys and Questionnaires ; Vaccination

OBJECTIVEThe expanded programme on immunization (EPI) is an important part of the social commonwealth projects providing health care service by the government, which benefits communities. Government has the responsibility for EPI's financing which should be covered by the national budget. It is essential that the cost of EPI service be scientifically estimated to provide propriety information for policy makers.

METHODSThis study, using the cost accounting theory of health economics, to calculate EPI service cost at different levels. 3 provinces, 3 prefectures, 9 counties, 18 towns and 12 villages were selected from three provinces Guizhou, Heilongjiang and Zhejiang from the western, central and eastern regions of the country.

RESULTSThe average costs for one EPI-targeted child in Guizhou, Heilongjiang and Zhejiang, were 15.68 Yuan, 29.00 Yuan and 31.09 Yuan, and the costs for one dose were 10.99 Yuan, 18.64 Yuan and 16.51 Yuan, respectively. The costs for complete immunization program for one child were 131.88 Yuan, 242.32 Yuan and 280.67 Yuan, respectively. The main factors affecting the cost would include the average personnel cost (salary and benefit cost) by different economic levels of areas, the number of EPI items developed, and the number of total doses for one child.

CONCLUSION(1) Obvious differences were found between different areas. (2) The proportion of the cost was not reasonably set because of the shortage of input. (3) Guideline for different areas to compensate the working item cost according to the number of the items should be formulated.

China ; epidemiology ; Cost-Benefit Analysis ; Health Expenditures ; statistics & numerical data ; Humans ; Immunization Programs ; economics ; organization & administration ; Population Surveillance ; methods ; Program Evaluation ; Socioeconomic Factors ; Vaccination ; statistics & numerical data