Matthew M. Davis1, Acham Gebremariam
1, Anne E. Cowan
1, Jack RC Wheeler
2, and Gary L. Freed
3. (1) Division of General Pediatrics, University of Michigan, 300 North Ingalls, Room 6E06, Campus Box 0456, Ann Arbor, MI, USA, (2) Health Management and Policy, School of Public Health, University of Michigan, Observatory Dr, Ann Arbor, MI, USA, (3) Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, 300 North Ingalls, Room 6E06, Campus Box 0456, Ann Arbor, MI, USA
KEYWORD1:
vaccine shortage, child, expenditures
BACKGROUND:
Supply shortages of childhood vaccines in 2001-2002 were followed by increases in federally negotiated purchase prices for some vaccines. Escalating public-sector expenditures related to future vaccine shortages may threaten the success of federal and state immunization initiatives.
OBJECTIVE:
To project the economic impact of childhood vaccine shortages from the present through the year 2020.
METHOD:
As the basis for simulations of shortages using Monte Carlo modeling, we used a previously developed model of future vaccine purchase expenditures per child (through age 6) at public-sector prices that anticipates as many as a total of 13 universally recommended vaccines for children by the year 2020. We estimated the economic impact of 3 future shortage scenarios: no further shortages, “optimistic” (random chance of 0-2 vaccines in shortage in a given year), and “pessimistic” (random chance of 0 to all recommended vaccines in shortage in a given year). We assumed when shortages occurred that vaccine prices would increase 5%-25% above expected annual increases and conducted sensitivity analyses.
RESULT:
Assuming no further childhood vaccine shortages, the predicted cost to immunize through age 6 years will be $2,217 per child (in 2002 US$) by the year 2020. In shortage scenarios, “optimistic” models yielded an estimate of $2,235 per child, whereas the “pessimistic” estimate was $2,376 per child. Worst-case sensitivity analysis reflecting 25%-50% price increases for vaccines in shortage increased the “pessimistic” estimate to $2,593 per child.
CONCLUSION:
Our analysis indicates that childhood vaccine shortages are expected to increase the total public-sector purchase cost for childhood vaccines from 1% to 17% by the year 2020, depending on the magnitude of price increases for vaccines in shortage.
LEARNINGOBJECTIVES:
Future vaccine shortages are expected to have economic effects that are small relative to the overall vaccine purchase expenditures per child.
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