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Estimating the fiscal impact of three vaccination strategies in Italy

Published online by Cambridge University Press:  13 February 2020

Matteo Ruggeri Open the ORCID record for Matteo Ruggeri [Opens in a new window] ,
Eugenio Di Brino Open the ORCID record for Eugenio Di Brino [Opens in a new window]  and
Americo Cicchetti
Matteo Ruggeri
Affiliation:
Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
Eugenio Di Brino*
Affiliation:
Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
Americo Cicchetti
Affiliation:
Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
*
Author for correspondence: Eugenio Di Brino, E-mail: [email protected]
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Abstract

Objectives

When assessing the economic value of vaccines, decision makers should adopt a full societal perspective. One approach for estimation of the fiscal impact of a disease is to use the human capital method to determine productivity losses. The aim of this study was to test an analytical framework developed for the estimation of the fiscal impacts of vaccination programs for influenza (FLU), pneumococcus (PC), and herpes zoster (HZ), in Italy.

Methods

We tested the framework in a two-stage analysis. First, we estimated the fiscal impact of the disease, second we performed a cost–benefit analysis of the individual benefits of vaccination against the cost of the vaccine. To estimate the fiscal impact of the diseases, the human capital approach was used. Epidemiological data were extrapolated from the literature. A Monte Carlo simulation enabled exploration of the uncertainty in the model variables.

Results

For FLU, assuming 2.1 million people infected, the total expected impact was EUR 999,371,520; the estimated fiscal impact was EUR 159,563,520. For PC, assuming 90,000 people infected, the total impact was EUR 148,055,040 and the estimated fiscal impact was EUR 23,639,040. For HZ, assuming 6,400 people infected, the total impact was EUR 4,777,200, with EUR 630,000 resulting from a decrease in fiscal taxation.

Conclusions

In conclusion, our work shows how traditional methods aimed at estimating the cost of illness from a social perspective can be improved by additionally considering the fiscal impact, which accounts for the decrease in fiscal revenues due to illness.

Keywords

Fiscal impactSocial costProductivity lossVaccination strategy
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 2 , April 2020 , pp. 133 - 138
Copyright
Copyright © Cambridge University Press 2020

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