Wenzhou Yu1, Ming Lu2, Huaqing Wang1, Lance Rodewald3, Saisai Ji1, Chao Ma1, Yixing Li1, Jingshan Zheng1, Yifan Song1, Miao Wang1, Yamin Wang1, Dan Wu1, Lei Cao1, Chunxiang Fan1, Xuan Zhang1, Yanmin Liu4. 1. National Immunization Program, Chinese Center for Disease Control and Prevention, No. 27, Nanwei Road, Xicheng District, Beijing, China. 2. National Health and Family Planning Commission of the People's Republic of China, No. 1, Xizhimenwai Street, Xicheng District, Beijing, China. 3. World Health Organization Office in China, 401, Dongwai Diplomatic Office Building, No. 23, Dong zhi men wai Street, Beijing, China. 4. National Immunization Program, Chinese Center for Disease Control and Prevention, No. 27, Nanwei Road, Xicheng District, Beijing, China. Electronic address: liuym@chinacdc.cn.
Abstract
OBJECTIVE: To estimate the costs of routine immunization (RI) services in China in 2015, to provide objective data relevant to investment in the Expanded Program on Immunization, and to contribute to global data on costing and financing of RI. METHODS: The study was conducted between January and March 2016. We selected 276 villages, 138 townships, 46 counties, and 40 prefectures from 15 provinces as investigation sites at random, stratified by eastern, middle, and western regions. Direct cost items included vaccines, personnel, cold chain, surveillance, communication, training, and supervision at the national, provincial, prefecture, county, township, and village levels. We obtained financial data from governmental and external sources. Indirect costs of RI included parents' transportation costs and productivity lost due to taking their children for vaccination. RESULTS: Total direct costs were $92.42 for each child fully immunized ($4.20/dose), which equates to $1529.55 million per birth cohort. RI costs were higher in the eastern region than in the western region, and higher than that of the central region. Vaccination coverage was positively associated with direct routine immunization costs. The cost of the recommended vaccines was $19.08/child and vaccine only accounted for 20.64% of total costs. Operational cost, including surveillance, communication, training and supervision, was $217.31/child, accounting for 14.21% of total cost. The indirect cost per child was $72.86; the total indirect cost was $1205.83 million for the birth cohort. Government investment in RI accounted for about 70% of total costs. Revenue from sales of private-sector vaccine supported the remaining 30% of RI costs. CONCLUSIONS: While government financing has increased, some operating costs continue to be provided from revenue generated by sales of Category 2 (private-sector) vaccines to families. China could benefit from bringing new and underutilized vaccines into the EPI system based on evidence that includes routine immunization vaccine and operations costs.
OBJECTIVE: To estimate the costs of routine immunization (RI) services in China in 2015, to provide objective data relevant to investment in the Expanded Program on Immunization, and to contribute to global data on costing and financing of RI. METHODS: The study was conducted between January and March 2016. We selected 276 villages, 138 townships, 46 counties, and 40 prefectures from 15 provinces as investigation sites at random, stratified by eastern, middle, and western regions. Direct cost items included vaccines, personnel, cold chain, surveillance, communication, training, and supervision at the national, provincial, prefecture, county, township, and village levels. We obtained financial data from governmental and external sources. Indirect costs of RI included parents' transportation costs and productivity lost due to taking their children for vaccination. RESULTS: Total direct costs were $92.42 for each child fully immunized ($4.20/dose), which equates to $1529.55 million per birth cohort. RI costs were higher in the eastern region than in the western region, and higher than that of the central region. Vaccination coverage was positively associated with direct routine immunization costs. The cost of the recommended vaccines was $19.08/child and vaccine only accounted for 20.64% of total costs. Operational cost, including surveillance, communication, training and supervision, was $217.31/child, accounting for 14.21% of total cost. The indirect cost per child was $72.86; the total indirect cost was $1205.83 million for the birth cohort. Government investment in RI accounted for about 70% of total costs. Revenue from sales of private-sector vaccine supported the remaining 30% of RI costs. CONCLUSIONS: While government financing has increased, some operating costs continue to be provided from revenue generated by sales of Category 2 (private-sector) vaccines to families. China could benefit from bringing new and underutilized vaccines into the EPI system based on evidence that includes routine immunization vaccine and operations costs.
Authors: Cara Bess Janusz; Abram L Wagner; Nina B Masters; Yaxing Ding; Ying Zhang; David W Hutton; Matthew L Boulton Journal: Vaccine Date: 2020-05-22 Impact factor: 3.641
Authors: Chathika Krishan Weerasuriya; Rebecca Claire Harris; Matthew Quaife; Christopher Finn McQuaid; Richard G White; Gabriela B Gomez Journal: Vaccines (Basel) Date: 2021-03-11
Authors: Gabriela B Gomez; Richard G White; Chathika K Weerasuriya; Rebecca C Harris; C Finn McQuaid; Fiammetta Bozzani; Yunzhou Ruan; Renzhong Li; Tao Li; Kirankumar Rade; Raghuram Rao; Ann M Ginsberg Journal: BMC Med Date: 2021-02-26 Impact factor: 8.775