Producing Standardized Country-Level Immunization Delivery Unit Cost Estimates

作者：Allison Portnoy, Kelsey Vaughan, Emma Clarke‐Deelder, Christian Suharlim, Stephen Resch, Logan Brenzel, Nicolas A. Menzies · 发表于：PharmacoEconomics · 年份：2020 · DOI：10.1007/s40273-020-00930-6 · 被引用次数：73 · 研究领域：Vaccine Coverage and Hesitancy、Bacterial Infections and Vaccines、Diphtheria, Corynebacterium, and Tetanus

BACKGROUND: To plan for the financial sustainability of immunization programs and make informed decisions to improve immunization coverage and equity, decision-makers need to know how much these programs cost beyond the cost of the vaccine. Non-vaccine delivery cost estimates can significantly influence the cost-effectiveness estimates used to allocate resources at the country level. However, many low- and middle-income countries (LMICs) do not have immunization delivery unit cost estimates available, or have estimates that are uncertain, unreliable, or old. We undertook a Bayesian evidence synthesis to generate country-level estimates of immunization delivery unit costs for LMICs. METHODS: From a database of empirical immunization costing studies, we extracted estimates of the delivery cost per dose for routine childhood immunization services, excluding vaccine costs. A Bayesian meta-regression model was used to regress delivery cost per dose estimates, stratified by cost category, against a set of predictor variables including country-level [gross domestic product per capita, reported diphtheria-tetanus-pertussis third dose coverage (DTP3), population, and number of doses in the routine vaccination schedule] and study-level (study year, single antigen or programmatic cost per dose, and financial or economic cost) predictors. The fitted prediction model was used to generate standardized estimates of the routine immunization delivery cost per dose for each LMIC for 2009-2018....