Economic impact of switching from partially combined vaccine "Pentaxim® and hepatitis B" to fully combined vaccine "Hexaxim®" in the Malaysian National Immunization Program.


Journal

BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677

Informations de publication

Date de publication:
05 Jan 2022
Historique:
received: 07 06 2021
accepted: 16 12 2021
entrez: 6 1 2022
pubmed: 7 1 2022
medline: 8 1 2022
Statut: epublish

Résumé

The decision to implement new vaccines should be supported by public health and economic evaluations. Therefore, this study was primarily designed to evaluate the economic impact of switching from partially combined vaccine (Pentaxim® plus hepatitis B) to fully combined vaccine (Hexaxim®) in the Malaysian National Immunization Program (NIP) and to investigate healthcare professionals (HCPs)' and parents'/caregivers' perceptions. In this economic evaluation study, 22 primary healthcare centers were randomly selected in Malaysia between December 2019 and July 2020. The baseline immunization schedule includes switching from Pentaxim® (four doses) and hepatitis B (three doses) to Hexaxim® (four doses), whereas the alternative scheme includes switching from Pentaxim® (four doses) and hepatitis B (three doses) to Hexaxim® (four doses) and hepatitis B (one dose) administered at birth. Direct medical costs were extracted using a costing questionnaire and an observational time and motion chart. Direct non-medical (cost for transportation) and indirect costs (loss of productivity) were derived from parents'/caregivers' questionnaire. Also, HCPs' and parent's/caregivers' perceptions were investigated using structured questionnaires. The cost per dose of Pentaxim® plus hepatitis B vs. Hexaxim® for the baseline scheme was Malaysian ringgit (RM) 31.90 (7.7 United States dollar [USD]) vs. 17.10 (4.1 USD) for direct medical cost, RM 54.40 (13.1 USD) vs. RM 27.20 (6.6 USD) for direct non-medical cost, RM 221.33 (53.3 USD) vs. RM 110.66 (26.7 USD) for indirect cost, and RM 307.63 (74.2 USD) vs. RM 155.00 (37.4 USD) for societal (total) cost. A similar trend was observed for the alternative scheme. Compared with Pentaxim® plus hepatitis B, total cost savings per dose of Hexaxim® were RM 137.20 (33.1 USD) and RM 104.70 (25.2 USD) in the baseline and alternative scheme, respectively. Eighty-four percent of physicians and 95% of nurses supported the use of Hexaxim® in the NIP. The majority of parents/caregivers had a positive perception regarding Hexaxim® vaccine in various aspects. Incorporation of Hexaxim® within Malaysian NIP is highly recommended because the use of Hexaxim® has demonstrated substantial direct and indirect cost savings for healthcare providers and parents/caregivers with a high percentage of positive perceptions, compared with Pentaxim® plus hepatitis B. Not applicable.

Sections du résumé

BACKGROUND BACKGROUND
The decision to implement new vaccines should be supported by public health and economic evaluations. Therefore, this study was primarily designed to evaluate the economic impact of switching from partially combined vaccine (Pentaxim® plus hepatitis B) to fully combined vaccine (Hexaxim®) in the Malaysian National Immunization Program (NIP) and to investigate healthcare professionals (HCPs)' and parents'/caregivers' perceptions.
METHODS METHODS
In this economic evaluation study, 22 primary healthcare centers were randomly selected in Malaysia between December 2019 and July 2020. The baseline immunization schedule includes switching from Pentaxim® (four doses) and hepatitis B (three doses) to Hexaxim® (four doses), whereas the alternative scheme includes switching from Pentaxim® (four doses) and hepatitis B (three doses) to Hexaxim® (four doses) and hepatitis B (one dose) administered at birth. Direct medical costs were extracted using a costing questionnaire and an observational time and motion chart. Direct non-medical (cost for transportation) and indirect costs (loss of productivity) were derived from parents'/caregivers' questionnaire. Also, HCPs' and parent's/caregivers' perceptions were investigated using structured questionnaires.
RESULTS RESULTS
The cost per dose of Pentaxim® plus hepatitis B vs. Hexaxim® for the baseline scheme was Malaysian ringgit (RM) 31.90 (7.7 United States dollar [USD]) vs. 17.10 (4.1 USD) for direct medical cost, RM 54.40 (13.1 USD) vs. RM 27.20 (6.6 USD) for direct non-medical cost, RM 221.33 (53.3 USD) vs. RM 110.66 (26.7 USD) for indirect cost, and RM 307.63 (74.2 USD) vs. RM 155.00 (37.4 USD) for societal (total) cost. A similar trend was observed for the alternative scheme. Compared with Pentaxim® plus hepatitis B, total cost savings per dose of Hexaxim® were RM 137.20 (33.1 USD) and RM 104.70 (25.2 USD) in the baseline and alternative scheme, respectively. Eighty-four percent of physicians and 95% of nurses supported the use of Hexaxim® in the NIP. The majority of parents/caregivers had a positive perception regarding Hexaxim® vaccine in various aspects.
CONCLUSIONS CONCLUSIONS
Incorporation of Hexaxim® within Malaysian NIP is highly recommended because the use of Hexaxim® has demonstrated substantial direct and indirect cost savings for healthcare providers and parents/caregivers with a high percentage of positive perceptions, compared with Pentaxim® plus hepatitis B.
TRIAL REGISTRATION BACKGROUND
Not applicable.

Identifiants

pubmed: 34986870
doi: 10.1186/s12913-021-07428-7
pii: 10.1186/s12913-021-07428-7
pmc: PMC8734051
doi:

Substances chimiques

DTaP-IPV-HB-PRP-T vaccine 0
Diphtheria-Tetanus-Pertussis Vaccine 0
Haemophilus Vaccines 0
Hepatitis B Vaccines 0
Pentavac 0
Poliovirus Vaccine, Inactivated 0
Vaccines, Combined 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

34

Informations de copyright

© 2022. The Author(s).

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Auteurs

Syed Mohamed Aljunid (SM)

International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Kuala Lumpur, Malaysia. saljunid@gmail.com.
Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait. saljunid@gmail.com.
Malaysian Health Economic Association (MAHEA), International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Kuala Lumpur, Malaysia. saljunid@gmail.com.

Lama Al Bashir (L)

International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Kuala Lumpur, Malaysia.
Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Bangi, Selangor, Malaysia.

Aniza Binti Ismail (AB)

Malaysian Health Economic Association (MAHEA), International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Kuala Lumpur, Malaysia.
Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Bangi, Selangor, Malaysia.

Azimatun Noor Aizuddin (AN)

International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Kuala Lumpur, Malaysia.
Malaysian Health Economic Association (MAHEA), International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Kuala Lumpur, Malaysia.
Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Bangi, Selangor, Malaysia.

S A Zafirah Abdul Rashid (SAZA)

International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, National University of Malaysia, Kuala Lumpur, Malaysia.
Casemix Solutions Sdn Bhd, International Centre for Casemix and Clinical Coding,Hospital Canselor Tuanku Muhriz, National University of Malaysia, Kuala Lumpur, Malaysia.

Amrizal Muhammad Nur (AM)

Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait.

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