Return on Investment (ROI) of Three Vaccination Programmes in Italy: HPV at 12 Years, Herpes Zoster in Adults, and Influenza in the Elderly

• Published in: Vaccines (Basel) Vol. 11; no. 5; p. 924
• Main Authors: Barbieri, Marco, Boccalini, Sara
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.04.2023; MDPI
• Subjects: Adolescents; Adults; Age; Chronic obstructive pulmonary disease; Cost benefit analysis; Cost control; Developing countries; Discount rates; Disease prevention; Economic aspects; flu; Forecasts and trends; Herpes zoster; Herpesvirus vaccines; Hospitalization; HPV; Human papillomavirus; Immunization; Influenza; Influenza vaccines; LDCs; Older people; Public health; Rate of return; Return on investment; ROI; vaccination; Vaccines; Italy; models; herpes zoster; ROI; flu; HPV; vaccination
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines11050924

The calculation of the return on investment (ROI) allows the estimation of the opportunity cost of a series of interventions and can therefore help to make allocative choices. The objective of this study is to estimate the ROI of three vaccinations (HPV for adolescents, HZ for adults, and influenza for the elderly) in the Italian context, considering the impact of increasing vaccination coverage based on target objectives of the National Immunization Plan (PNPV) 2017-2019 and accounting for different eligibility criteria of each vaccination. Three separate static cohort models were constructed, including the eligible population for these vaccinations on the basis of the PNPV 2017-2019 and following this population until death (lifetime horizon) or until vaccination waning. Each model compares the level of investment at current vaccine coverage rates (current VCRs scenario) with that of optimal NIP target VCRs with a non-vaccination scenario. The ROI for HPV vaccination was the highest among the programs compared and was always above 1 (range: 1.4-3.58), while lower values were estimated for influenza vaccination in the elderly (range 0.48-0.53) and for vaccination against HZ (range: 0.09-0.27). Our analysis showed that a significant proportion of savings generated by vaccination programs occurred outside the NHS perspective and might often not be estimated with other forms of economic evaluation.