Cost consequence minimization and budget impact model for introducing the fully liquid combined acellular hexavalent vaccine into the Dominican Republic’s expanded immunization plan

BACKGROUND: This study evaluates the economic impact of incorporating a fully liquid combined acellular hexavalent vaccine within Expanded Program on Immunizations (EPI) of the Dominican Republic (DR). RESEARCH DESIGN AND METHODS: A cost-consequence analysis model was conducted comparing two different vaccination schemes in 1 year. Inputs and costs were extracted from both official and literature sources. Two vaccination schedules were assessed: 3 + 0 and 3 + 1. Additionally, a 5-year budget impact analysis evaluated the implications of introducing the hexavalent vaccine into the EPI. The analysis was performed from both a third-party payer and considering productivity losses. (1 USD = 55.67, 2023). RESULTS: The hexavalent vaccine resulted in an increase in total costs of 43.1% and 57.9% for the 3 + 0 and 3 + 1 scenarios. Vaccine acquisition costs drove this increase. However, adverse events, logistics cost and productivity losses were reduced by 51.87%-74.87%, 38.20%-49.23%, and 28.5%-44.9% (3 + 0-3 + 1) respectively. The budget impact analysis showed an overall budget increase of 61.7% and 80.2% with a 37.5% and 50% reduction in total vaccine doses administered, for the 3 + 0 and 3 + 1 scenarios. CONCLUSION: The incorporation of the hexavalent vaccine increases spending but reduces adverse events, logistics cost, and productivity losses, supporting modernization of the DR immunization program.