Trends in governmental expenditure on vaccination programmes in the Netherlands, a historical analysis

Maarten van Wijhe, Pieter de Boer, Herman de Jong, Hans van Vliet, Jacco Wallinga, Maarten Postma

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background
Health economic evaluations are often required before implementing a vaccination programme. Such evaluations rarely consider the historical context of a vaccination programme. We review the financial history of vaccination programmes in the Netherlands, and compare these to demographic and macroeconomic developments as well as avoided mortality burden.

Methods
Previously uncatalogued historical expenditures on the Dutch National Immunisation Programme (NIP) and influenza vaccination were obtained from official reports. Costs were adjusted for inflation using Consumer Price Indices and expressed in Euro of 2016. Estimates on mortality burden averted were obtained from previous research and used to calculate the ratio of expenses to averted mortality burden for vaccinations against diphtheria, tetanus, pertussis, polio, measles, mumps and rubella for birth cohorts 1953–1992.

Results
Developments towards a uniform government funded NIP started early 1950s with vaccinations against diphtheria, pertussis and tetanus, culminating in its official launch in 1957 together with polio vaccinations. Since the 1980s, expenditure increased nearly five-fold mostly due to the addition of new vaccines, while spending on already implemented vaccinations tended to decline. Overall, expenditure increased from € 5 million in 1957 to € 93 million in 2014. Relative to total healthcare expenditure, the NIP contributed little, ranging between 0.05% and 0.14%. Spending on influenza vaccination increased from € 37 million in 1996 to € 52 million in 2014, while relative to total healthcare expenditure it decreased from 0.069% to 0.055%. In 2014, 0.15% of healthcare expenditure and € 533 per birth was spent on vaccination programmes. Overall, for birth cohorts 1953–1992, € 5.4 thousand (95% confidence interval: 4.0–7.3) was expended per year-of-life-lost averted.

Conclusion
The actual costs per year-of-life gained are more favorable than estimated here since averted medical costs were not included. Although expenditure on vaccination programmes increased substantially, the contribution to overall healthcare expenditure remained small.
OriginalsprogEngelsk
TidsskriftVaccine
Vol/bind37
Udgave nummer38
Sider (fra-til)5698-5707
Antal sider10
ISSN0264-410X
DOI
StatusUdgivet - 13 aug. 2019

Citer dette

van Wijhe, Maarten ; de Boer, Pieter ; de Jong, Herman ; van Vliet, Hans ; Wallinga, Jacco ; Postma, Maarten. / Trends in governmental expenditure on vaccination programmes in the Netherlands, a historical analysis. I: Vaccine. 2019 ; Bind 37, Nr. 38. s. 5698-5707.
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title = "Trends in governmental expenditure on vaccination programmes in the Netherlands, a historical analysis",
abstract = "BackgroundHealth economic evaluations are often required before implementing a vaccination programme. Such evaluations rarely consider the historical context of a vaccination programme. We review the financial history of vaccination programmes in the Netherlands, and compare these to demographic and macroeconomic developments as well as avoided mortality burden.MethodsPreviously uncatalogued historical expenditures on the Dutch National Immunisation Programme (NIP) and influenza vaccination were obtained from official reports. Costs were adjusted for inflation using Consumer Price Indices and expressed in Euro of 2016. Estimates on mortality burden averted were obtained from previous research and used to calculate the ratio of expenses to averted mortality burden for vaccinations against diphtheria, tetanus, pertussis, polio, measles, mumps and rubella for birth cohorts 1953–1992.ResultsDevelopments towards a uniform government funded NIP started early 1950s with vaccinations against diphtheria, pertussis and tetanus, culminating in its official launch in 1957 together with polio vaccinations. Since the 1980s, expenditure increased nearly five-fold mostly due to the addition of new vaccines, while spending on already implemented vaccinations tended to decline. Overall, expenditure increased from € 5 million in 1957 to € 93 million in 2014. Relative to total healthcare expenditure, the NIP contributed little, ranging between 0.05{\%} and 0.14{\%}. Spending on influenza vaccination increased from € 37 million in 1996 to € 52 million in 2014, while relative to total healthcare expenditure it decreased from 0.069{\%} to 0.055{\%}. In 2014, 0.15{\%} of healthcare expenditure and € 533 per birth was spent on vaccination programmes. Overall, for birth cohorts 1953–1992, € 5.4 thousand (95{\%} confidence interval: 4.0–7.3) was expended per year-of-life-lost averted.ConclusionThe actual costs per year-of-life gained are more favorable than estimated here since averted medical costs were not included. Although expenditure on vaccination programmes increased substantially, the contribution to overall healthcare expenditure remained small.",
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Trends in governmental expenditure on vaccination programmes in the Netherlands, a historical analysis. / van Wijhe, Maarten; de Boer, Pieter; de Jong, Herman; van Vliet, Hans; Wallinga, Jacco; Postma, Maarten.

I: Vaccine, Bind 37, Nr. 38, 13.08.2019, s. 5698-5707.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Trends in governmental expenditure on vaccination programmes in the Netherlands, a historical analysis

AU - van Wijhe, Maarten

AU - de Boer, Pieter

AU - de Jong, Herman

AU - van Vliet, Hans

AU - Wallinga, Jacco

AU - Postma, Maarten

PY - 2019/8/13

Y1 - 2019/8/13

N2 - BackgroundHealth economic evaluations are often required before implementing a vaccination programme. Such evaluations rarely consider the historical context of a vaccination programme. We review the financial history of vaccination programmes in the Netherlands, and compare these to demographic and macroeconomic developments as well as avoided mortality burden.MethodsPreviously uncatalogued historical expenditures on the Dutch National Immunisation Programme (NIP) and influenza vaccination were obtained from official reports. Costs were adjusted for inflation using Consumer Price Indices and expressed in Euro of 2016. Estimates on mortality burden averted were obtained from previous research and used to calculate the ratio of expenses to averted mortality burden for vaccinations against diphtheria, tetanus, pertussis, polio, measles, mumps and rubella for birth cohorts 1953–1992.ResultsDevelopments towards a uniform government funded NIP started early 1950s with vaccinations against diphtheria, pertussis and tetanus, culminating in its official launch in 1957 together with polio vaccinations. Since the 1980s, expenditure increased nearly five-fold mostly due to the addition of new vaccines, while spending on already implemented vaccinations tended to decline. Overall, expenditure increased from € 5 million in 1957 to € 93 million in 2014. Relative to total healthcare expenditure, the NIP contributed little, ranging between 0.05% and 0.14%. Spending on influenza vaccination increased from € 37 million in 1996 to € 52 million in 2014, while relative to total healthcare expenditure it decreased from 0.069% to 0.055%. In 2014, 0.15% of healthcare expenditure and € 533 per birth was spent on vaccination programmes. Overall, for birth cohorts 1953–1992, € 5.4 thousand (95% confidence interval: 4.0–7.3) was expended per year-of-life-lost averted.ConclusionThe actual costs per year-of-life gained are more favorable than estimated here since averted medical costs were not included. Although expenditure on vaccination programmes increased substantially, the contribution to overall healthcare expenditure remained small.

AB - BackgroundHealth economic evaluations are often required before implementing a vaccination programme. Such evaluations rarely consider the historical context of a vaccination programme. We review the financial history of vaccination programmes in the Netherlands, and compare these to demographic and macroeconomic developments as well as avoided mortality burden.MethodsPreviously uncatalogued historical expenditures on the Dutch National Immunisation Programme (NIP) and influenza vaccination were obtained from official reports. Costs were adjusted for inflation using Consumer Price Indices and expressed in Euro of 2016. Estimates on mortality burden averted were obtained from previous research and used to calculate the ratio of expenses to averted mortality burden for vaccinations against diphtheria, tetanus, pertussis, polio, measles, mumps and rubella for birth cohorts 1953–1992.ResultsDevelopments towards a uniform government funded NIP started early 1950s with vaccinations against diphtheria, pertussis and tetanus, culminating in its official launch in 1957 together with polio vaccinations. Since the 1980s, expenditure increased nearly five-fold mostly due to the addition of new vaccines, while spending on already implemented vaccinations tended to decline. Overall, expenditure increased from € 5 million in 1957 to € 93 million in 2014. Relative to total healthcare expenditure, the NIP contributed little, ranging between 0.05% and 0.14%. Spending on influenza vaccination increased from € 37 million in 1996 to € 52 million in 2014, while relative to total healthcare expenditure it decreased from 0.069% to 0.055%. In 2014, 0.15% of healthcare expenditure and € 533 per birth was spent on vaccination programmes. Overall, for birth cohorts 1953–1992, € 5.4 thousand (95% confidence interval: 4.0–7.3) was expended per year-of-life-lost averted.ConclusionThe actual costs per year-of-life gained are more favorable than estimated here since averted medical costs were not included. Although expenditure on vaccination programmes increased substantially, the contribution to overall healthcare expenditure remained small.

KW - Vaccination

KW - Finance

KW - History

KW - Expenditure

KW - Netherlands

KW - prevention

U2 - 10.1016/j.vaccine.2019.07.097

DO - 10.1016/j.vaccine.2019.07.097

M3 - Journal article

VL - 37

SP - 5698

EP - 5707

JO - Vaccine

JF - Vaccine

SN - 0264-410X

IS - 38

ER -