OBJECTIVES: To evaluate the economic impact of the pediatric National Immunization Program (NIP) in Italy from both healthcare sector and societal perspectives.
METHODS: An economic model was developed to focus on the 10 mandatory vaccinations and 3 recommended ones included in Italy’s NIP for children aged 0-10 years. Separate decision trees were used to model each vaccine-preventable pathogen, including diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae B, hepatitis B, measles, mumps, rubella, Neisseria meningitidis, rotavirus, Streptococcus pneumoniae, and varicella. The 2020 birth cohort (n=420,084) was followed over their lifetime, with the model projecting and comparing direct medical costs with and without immunization (based on current and pre–vaccine era disease incidence estimates, respectively). For the societal perspective, the model also included productivity loss costs associated with immunization and disease. The model estimated discounted incremental cases, disease-related deaths, life-years lost, quality-adjusted life-years lost, costs (2020 2021 euros), and an overall benefit-cost ratio (BCR).
RESULTS: Across the vaccine-preventable diseases targeted, the NIP is estimated to prevent 3.5 million cases of infections, 1,600 deaths, 46,900 800 life-years lost, and 67,000 quality-adjusted life-years lost. The NIP was associated with vaccination costs of €250 million from the healthcare sector perspective and €347 283 million from the societal perspective. Vaccination costs were fully offset by disease-related costs averted. Pediatric immunization was associated with €285 278 million in averted direct medical costs (BCR=2.1) and €1.65 billion in averted societal costs (BCR=5.36.6).
CONCLUSIONS: The Italian pediatric NIP brings large-scale prevention of disease-related morbidity, mortality, and associated costs. This highlights the value of continued investment in pediatric immunization.
