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Table 2 Costs included

From: Valuing the cost of improving Chilean primary vaccination: a cost minimization analysis of a hexavalent vaccine

Healthcare resource

Value (US$)

Source

Outpatient clinic

13.97

Arancel MAI 2018 MINSAL, Chile [34]: https://www.fonasa.cl/sites/fonasa/prestadores/normativa/aranceles#modalidad-de-atencion-institucional%2D%2Dmai-

Pediatric hospitalization (day)

556

Arancel MAI 2018 MINSAL, Chile [35]: https://www.fonasa.cl/sites/fonasa/prestadores/normativa/aranceles#modalidad-de-atencion-institucional--mai-

Anti-pyretic (Paracetamol 100 mg/mL)

6.89

CENABAST, Chile [36]: https://www.cenabast.cl/compras-cenabast-vigentes

Travel to hospital (2 journeys per visit)

1.11

Assumption: It was assumed that the transfer to ambulatory as well as to the emergency and hospitalization, required 2 transfers. The reference was transfer by bus, which costs 740 Chilean pesos, with an exchange rate to 666.26 pesos per US$, corresponds to a cost of US$ 1.11.

Loss of working time to attend outpatients/hospital

32.99 (per day. Assume 1 day per OP visit and 1.5 days per hospitalization)

Assumption: The average value of a working day corresponds to 21,977.26 Chilean pesos, equivalent to US$ 32.99. It was assumed that the loss would be 1 day in case of transfer to outpatient clinic and 1.5 days in the case of hospitalization.

Price of hexavalent (DTaP-IPV-HepB-Hib) vaccine

19.80

PAHO [37]:https://www.paho.org/hq/index.php?option=com_docman&view=download&category_slug=vacunas-9980&alias=38125-fondo-rotatorio-precios-vacunas-2017-125&Itemid=270&lang=es

Price of IPV in pre-filled syringe

5.3

Sanofi Pasteur and PAHO [37]: https://www.paho.org/hq/index.php?option=com_docman&view=download&category_slug=vacunas-9980&alias=38125-fondo-rotatorio-precios-vacunas-2017-125&Itemid=270&lang=es

Price of IPV plus cost of syringe

2.1

Price of vial (US$ 1.9) + syringe, PAHO [37]: https://www.paho.org/hq/index.php?option=com_docman&view=download&category_slug=vacunas-9980&alias=38125-fondo-rotatorio-precios-vacunas-2017-125&Itemid=270&lang=es

Price of IPV where supply difficulties require two different presentations to be used

3.6

Average between pre-filled syringe and vial, PAHO [37]: https://www.paho.org/hq/index.php?option=com_docman&view=download&category_slug=vacunas-9980&alias=38125-fondo-rotatorio-precios-vacunas-2017-125&Itemid=270&lang=es

Price of the bivalent oral polio vaccine (10-dose bottle)

0.32 (allowing for wastage)

PAHO [37]: https://www.paho.org/hq/index.php?option=com_docman&view=download&category_slug=vacunas-9980&alias=38125-fondo-rotatorio-precios-vacunas-2017-125&Itemid=270&lang=es

Price of the pentavalent (DTwP-Hib-HepB) vaccine (per dose)

2.85

Last adjudicated bidder for the pentavalent vaccine: GSK at US$ 1898 x dose. http://www.mercadopublico.cl/Procurement/Modules/RFB/DetailsAcquisition.aspx?qs=K4WQ9V4g07z52TulmJTwrg==

Administration of vaccine (12 mins)

5.69 (Nursing assistant/hr)

Assumption: Includes: undressing the child, preparing the vaccine, applying, and registering in all documents and in the Nominal Registration System. It was assumed that the salary of a Nursing Assistant (who administers the vaccine at the vaccination center) would be 500,000 Chilean pesos, corresponding to 2727 Chilean pesos per day for 22 days per month from Monday to Friday. If the working day was 6 h, then the value of nurses time for the hour would be 3788 Chilean pesos, US$ 5.69)

Additional distribution costs of pentavalent (DTwP-Hib-HepB) plus polio vaccine

0.15

Assumption: A higher cost was assumed for distribution of vaccines in the pentavalent arm simultaneously with the polio vaccine. The cost of distribution per dose of vaccine was US$ 0.15. This cost was provided Sanofi Pasteur Chile from internal data.

Delivery costs of vaccine

3120 (per quarter)

Assumption: According to the size of the boxes, 9259 doses would be required to complete 1 cubic meter. Each maintenance panel was 1 cubic meter. The total doses would equal 104 panels, but an adequate stock per quarter was assumed with quarterly deliveries. The panel requirement was 26 per quarter (each month of the quarter) and with a cost of US$ 40 per panel per month, makes a total quarterly cost of US$ 3120. This cost was provided Sanofi Pasteur Chile from internal data.

Level of errors in non-hexavalent vaccine program associated with simultaneous vaccination requirementsa

1%

Assumption: These errors could be due to the lack of inputs and the parents’ discomfort in front of the number of applications on the same day, with the refusal to accept it. This percentage was the result of consulting vaccination centers.

Private purchase of hexavalent (DTaP-IPV-HepB-Hib) vaccine

70.92

Based on sales in 2016 in Chile, 3.1% of the eligible population purchase the vaccine privately and thus would save the healthcare system US$ 2,194,580

  1. aFor example, administration of all required vaccines at any scheduled visit may not be strictly according to the national schedule due to limits in stock availability or parental decision, which necessitates additional visits to receive all required vaccines (with their associated costs)