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

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). 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). 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. The incorporation of the hexavalent vaccine increases spending but reduces adverse events, logistics cost, and productivity losses, supporting modernization of the DR immunization program.