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Open AccessArticle

Cost Effectiveness and Budget Impact Analyses of Influenza Vaccination for Prisoners in Thailand: An Application of System Dynamic Modelling

1
Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
2
International Health Policy Program (IHPP), Ministry of Public Health, Nonthaburi 11000, Thailand
3
Division of Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(4), 1247; https://doi.org/10.3390/ijerph17041247
Received: 22 December 2019 / Revised: 31 January 2020 / Accepted: 8 February 2020 / Published: 14 February 2020
(This article belongs to the Special Issue Health and Health Care Access of Vulnerable Populations)
Influenza outbreaks in Thai prisons were increasing in number every year and to address this, the Thai Ministry of Public Health (MOPH) initiated a policy to promote vaccination for prisoners. The objective of this study was to assess the cost effectiveness and budget impact of the influenza vaccination policy for prisoners in Thailand. The study obtained data from the Division of Epidemiology, Department of Disease Control (DDC), MOPH. Deterministic system dynamic modelling was exercised to estimate the financial implication of the vaccination programme in comparison with routine outbreak control. The incremental cost-effectiveness ratio (ICER) was calculated via a DDC perspective. The reproductive number was estimated at 1.4. A total of 143 prisons across the country (375,763 prisoners) were analysed. In non-vaccination circumstances, the total healthcare cost amounted to 174.8 million Baht (US$ 5.6 million). Should all prisoners be vaccinated, the total healthcare cost would reduce to 90.9 million Baht (US$ 2.9 million), and 46.8 million Baht (US$ 1.5 million) of this is related to the vaccination. The ICER of vaccination (compared with routine outbreak control) varied between 39,738.0 to 61,688.3 Baht per disability-adjusted life year (DALY) averted (US$ 1281.9–1989.9). Should the vaccination cover 30% of the prisoners, the ICER would be equal to 46,866.8 Baht (US$ 1511.8) per DALY averted with the budget burden amounted to Baht (US$ 4.8 million). The vaccination programme would become more cost-effective if the routine outbreak control was intensified. In summary, the vaccination programme was a cost-effective measure to halt influenza outbreak amongst prisoners. Further primary studies that aim to assess the actual impact of the programme are recommended. View Full-Text
Keywords: influenza; prisoners; vaccine; cost effectiveness; budget impact; Thailand influenza; prisoners; vaccine; cost effectiveness; budget impact; Thailand
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Suphanchaimat, R.; Doung-ngern, P.; Ploddi, K.; Suthachana, S.; Phaiyarom, M.; Pachanee, K.; Chaifoo, W.; Iamsirithaworn, S. Cost Effectiveness and Budget Impact Analyses of Influenza Vaccination for Prisoners in Thailand: An Application of System Dynamic Modelling. Int. J. Environ. Res. Public Health 2020, 17, 1247.

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