| DOI: 10.29090/psa.2019.01.017.0052 | Pharm Sci Asia 2019; 46(1), 46-53 |
Cost analysis of pilot school-based HPV vaccination program in two provinces of Lao PDRArthorn Riewpaiboon1*, Chansay Pathammavong2, Kimberly Fox2, Raymond Hutubessy4
1 Division of Social and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand.
2 EPI program, Ministry of Health, Lao People's Democratic Republic.
3 Vaccine Preventable Diseases, World Health Organization, Western Pacific Regional Office, Philippines.
4 Initiative for Vaccines Research, World Health Organization, Avenue Appia, 1211 Geneva 27, Switzerland.
Cancers including cervical cancer are leading causes of mortality in Lao PDR. Human papillomavirus (HPV) vaccination has been introduced as a pilot project. As a part the evaluation, program cost of the school-based vaccination was estimated. We employed an ingredient-based/ bottom-up costing study of incremental vaccine delivery cost using the WHO Cervical Cancer Prevention and Control Costing Tool (C4P). Both financial and economic costs are measured from the Ministry of Health perspective covering central supply unit to service provider levels. Costs are composed of labor cost and material cost but costs of building, vehicle and cold chain equipment are not included, except for extra cold chain equipment. Costs are presented in nominal value for the year 2013 (USD 1=7,855 LAK) in terms of total cost, cost component and unit cost. Scenarios for both 3- and 2-dose vaccination were explored. In two pilot provinces, there are 22 districts, 107 health centers, 917 schools and 13,558 target girls. We found that, with 100% coverage, the total costs of the 3-dose program were USD 106,677 and USD 135,479 for financial and economic cost, respectively. In terms of cost proportion by type of activities, service delivery comprised the highest percentage of economic cost (41.7%). For financial cost, supervision/AEFI comprised 42.5% and was the largest component. Costs per vaccination dose were USD 2.62 and USD 3.33 for financial and economic perspectives, respectively. Costs per fully immunized girl (FIG) for financial and economic perspective were USD 7.87 and USD 9.99, respectively. For a 2-dose vaccination scenario, costs per FIG were USD 5.7 and USD 7.9 for financial and economic cost, respectively. In conclusion, the overall cost of HPV vaccination program of Lao PDR was found to be in range of other countries, particularly those with similar features. Using a 2-dose vaccination schedule instead of a 3-dose schedule could save approximately one-third of the recurrent cost.
Keyword:
Cost analysis; Immunization programs; Human papillomavirus vaccine; Lao PDR
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