OBJECTIVES: To evaluate the economic impact of the pediatric immunization program (PIP) in Belgium from both healthcare payer and societal perspectives.
METHODS: An economic model was developed focusing on the 6 vaccines included in Belgium’s PIP, recommended in children aged 0-10 years. Separate decision trees were used to model each disease (i.e., diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae B, hepatitis B, measles, mumps, rubella, pneumococcal, rotavirus, and meningococcal C). The 2018 birth cohort was followed over their lifetime, with the model projecting and comparing direct medical costs with and without immunization (based on current and pre–vaccine era disease incidence estimates, respectively). For the societal perspective, the model also included productivity loss costs associated with immunization and disease. The model estimated discounted incremental cases, disease-related deaths, life-years lost, quality-adjusted life-years lost, costs (2020 Euros), and an overall benefit-cost ratio (BCR). Scenarios considering hypothetical inclusion of varicella and meningococcal B immunizations were conducted.
RESULTS: Across all 12 diseases, the PIP prevented more than 220,000 cases of infections, 200 deaths, 7,000 lifeyears lost, and 7,000 quality-adjusted life-years lost. The PIP was associated with vaccination costs of over €90 million from the healthcare payer perspective and over €120 million from the societal perspective. Vaccination costs were fully offset by disease-related costs averted. Pediatric immunization was associated with over €30 million in averted direct medical costs (BCR = 1.4) and over €240 million averted societal costs (BCR = 3.0). Estimates of the societal value of the PIP were similar when hypothetical introductions of varicella (BCR = 2.9) or meningococcal B (BCR = 2.5) immunizations were considered.
CONCLUSIONS: The PIP brings large-scale prevention of disease-related morbidity, premature mortality, and associated costs, which has not been systematically assessed before in Belgium. This highlights the value of continued investment in the PIP.
