Estimating the Costs of theMass Vaccination CampaignAgainst Hepatitis B in IranianAdolescents

Abstract

Background: In order to extend HBV immunization to twenty-five-year old adolescents, Ministry of Health and Medical Education (MOH & ME) in Iran has decided to implement HBV mass vaccination campaign for adolescents who were born from 1989 to 1992. The first three-round campaign covering 1989 born adolescents was implemented in 2007 in Iran. This study was conducted for cost estimation and analysis of HBV vaccination campaign for adolescents implemented in 2007 in Iran.

Materials andMethods: This cost analysis study was conducted applying health system perspective. The cost variables considered in this study were recurrent costs, personnel costs, publicity costs, transportation costs and overhead cost. We gathered the required data to estimate recurrent costs, national-level supervision and publicity from existing data and through interview with experts in MOH & ME. To estimate vaccine administration cost, provincial supervision cost and outreach teams' costs, we gathered the data from one or some of the provinces, then, we expanded the results to the country. We used recommended proportions by WHO to estimate transportation and overhead costs. We used administrative data reported from universities of medical sciences to estimate vaccination coverage. Sensitivity analysis was applied.

Results: Total cost for three rounds of the campaign was estimated as 83615 billion IR Rials including 24% for recurrent costs, 42% for personnel costs, 31% for transportation costs, 0.1% for publicity costs and 3% for overhead costs. Total cost was estimated as 21000 IR Rials per dose administered. Sensitivity analysis indicated that increasing campaign coverage and using under 20 year-old vaccine dosage will decrease the cost to 17500 IR Rials per dose administered. On the other hand, decreasing campaign coverage and using above 20 year-old vaccine dosage will increase the cost to 23000 IR Rials.

Conclusion: The costs in this campaign are much lower than that in similar programs in developed countries and will be even decreased if some revisions, particularly in vaccine dosage are considered. Publicity costs have been too low and needs more attention in future campaigns. The findings in this study provided evidence to support the resource value, which MOH & ME will be requested for future campaigns.