The costs of home delivery of a birth dose of hepatitis B vaccine in a prefilled syringe in Indonesia.
OBJECTIVE
To provide global policy-makers with decision-making information for developing strategies for immunization of infants with a birth dose of hepatitis B vaccine, this paper presents a retrospective cost analysis, conducted in Indonesia, of delivering this vaccine at birth using the Uniject prefill injection device.


METHODS
Incremental costs or cost savings associated with changes in the hepatitis B immunization programme were calculated using sensitivity analysis to vary the estimates of vaccine wastage rates and prices for vaccines and injection devices, for the birth dose of hepatitis B vaccine.


RESULTS
The introduction of hepatitis B vaccine prefilled in Uniject (HB-Uniject) single-dose injection devices for use by midwives for delivering the birth dose is cost-saving when the wastage rate for multidose vials is greater than 33% (Uniject is a trademark of BD, Franklin Lakes, NJ, USA).


CONCLUSIONS
The introduction of HB-Uniject for birth-dose delivery is economically worthwhile and can increase coverage of the critical birth dose, improve resource utilization, reduce transmission of hepatitis B and promote injection safety.
Levin
Carol E
CE
Program for Appropriate Technology in Health, Seattle, WA 98107, USA. clevin@path.org
Nelson
Carib M
CM
Widjaya
Anton
A
Moniaga
Vanda
V
Anwar
Chairiyah
C
D002662:Child Health Services / Q000191:economics*; D004209:Disposable Equipment; D006291:Health Policy; D006509:Hepatitis B / Q000191:economics / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000191:economics / Q000600:supply & distribution; D006699:Home Care Services / Q000191:economics*; D006801:Humans; D017589:Immunization Programs / Q000191:economics; D007214:Indonesia; D007231:Infant, Newborn; D007267:Injections / Q000191:economics / Q000295:instrumentation*; D012189:Retrospective Studies; D013594:Syringes / Q000191:economics*
D017325:Hepatitis B Vaccines