Economic evaluation of a combined DTPa, hepatitis B, polio, Hib vaccine. Potential impact of the introduction of Infanrix-Hexa in the French childhood immunisation schedule.

A new hexavalent combination vaccine, Infanrix-HEXA, including a recombinant hepatitis B vaccine in addition to the vaccines for diphtheria, tetanus, pertussis, poliomyelitis, and Haemophilus influenzae type B, has recently become available in France. The objectives of this study were to: (1) estimate the break-even price of Infanrix-Hexa for the National Sickness Fund; (2) evaluate its potential impact on vaccine coverage for hepatitis B and the corresponding budget impact. The public price of Infanrix-HEXA associated with a break-even point would be 53.77 euro. Our analyses suggested that other estimates based on a societal perspective including opportunity and indirect costs remained close to this value. The annual additional reimbursed cost of protecting an infant against the risk of hepatitis B would be 28.20 euro per child, or about 21 million euro for an annual cohort of 760,000 births (total cost, 35 million euro). The number of infants protected against hepatitis B could increase from 230,000 in the current situation to about 600,000.