title: Budget impact analysis of vaccination against Haemophilus influenzae type b as a part of a Pentavalent vaccine in the childhood immunization schedule of Iran.
abstract: BACKGROUND
  Health decision makers need to know the impact of the development of a new intervention on the public health and health care costs so that they can plan for economic and financial objectives. The aim of this study was to determine the budget impact of adding Haemophilus influenzae type b (Hib) as a part of a Pentavalent vaccine (Hib-HBV-DTP) to the national childhood immunization schedule of Iran.
  
  
  METHODS
  An excel-based model was developed to determine the costs of including the Pentavalent vaccine in the national immunization program (NIP), comparing the present schedule with the previous one (including separate DTP and hepatitis B vaccines). The total annual costs included the cost of vaccination (the vaccine and syringe) and the cost of Hib treatment. The health outcome was the estimated annual cases of the diseases. The net budget impact was the difference in the total annual cost between the two schedules. Uncertainty about the vaccine effectiveness, vaccination coverage, cost of the vaccine, and cost of the diseases were handled through scenario analysis.
  
  
  RESULTS
  The total cost of vaccination during 5 years was $18,060,463 in the previous program and $67,774,786 in the present program. Inclusion of the Pentavalent vaccine would increase the vaccination cost about $49 million, but would save approximately $6 million in the healthcare costs due to reduction of disease cases and treatment costs. The introduction of the Pentavalent vaccine resulted in a net increase in the healthcare budget expenditure across all scenarios from $43.4 million to $50.7 million.
  
  
  CONCLUSIONS
  The results of this study showed that the inclusion of the Pentavalent vaccine in the NIP of Iran had a significant impact on the health care budget and increased the financial burden on the government. Budget impact of including Pentavalent vaccine in the national immunization schedule of Iranᅟ.
authors.affiliation: Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Teimouri
authors.affiliation: Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.|Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Kebriaeezadeh
authors.affiliation: Center for Communicable Diseases Control, Ministry of Health and Education, Tehran, Iran.
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Zahraei
authors.affiliation: Department of Emergency Medicine, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: MohammadMahdi
authors.initials: M
authors.lastname: Gheiratian
authors.affiliation: Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. nikfar_sh@tums.ac.ir.|Evidence-Based Medicine Group, Pharmaceutical Sciences Research Group, Tehran University of Medical Sciences, Tehran, Iran. nikfar_sh@tums.ac.ir.
authors.forename: Shekoufeh
authors.initials: S
authors.lastname: Nikfar
mesh_terms: D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000191:economics*; D006192:Haemophilus Infections / Q000188:drug therapy / Q000191:economics; D018073:Haemophilus Vaccines / Q000191:economics*; D019741:Haemophilus influenzae type b / Q000276:immunology*; D017048:Health Care Costs; D017325:Hepatitis B Vaccines / Q000191:economics*; D006801:Humans; D007115:Immunization Schedule; D007492:Iran; D009313:National Health Programs / Q000191:economics*; D013594:Syringes / Q000191:economics; D014611:Vaccination / Q000191:economics; D017778:Vaccines, Combined / Q000191:economics*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D018073:Haemophilus Vaccines; D017325:Hepatitis B Vaccines; D017778:Vaccines, Combined
keywords: Budget impact analysis; Haemophilus influenzae type b; Immunization schedule; Iran; Pentavalent vaccine