Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-13T11:59:52.685Z Has data issue: false hasContentIssue false
  • English
  • Français

Estimating the fiscal impact of three vaccination strategies in Italy

Published online by Cambridge University Press:  13 February 2020

Matteo Ruggeri Open the ORCID record for Matteo Ruggeri [Opens in a new window] ,
Eugenio Di Brino Open the ORCID record for Eugenio Di Brino [Opens in a new window]  and
Americo Cicchetti
Matteo Ruggeri
Affiliation:
Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
Eugenio Di Brino*
Affiliation:
Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
Americo Cicchetti
Affiliation:
Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore, Rome, Italy
*
Author for correspondence: Eugenio Di Brino, E-mail: eugenio.dibrino@unicatt.it
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

When assessing the economic value of vaccines, decision makers should adopt a full societal perspective. One approach for estimation of the fiscal impact of a disease is to use the human capital method to determine productivity losses. The aim of this study was to test an analytical framework developed for the estimation of the fiscal impacts of vaccination programs for influenza (FLU), pneumococcus (PC), and herpes zoster (HZ), in Italy.

Methods

We tested the framework in a two-stage analysis. First, we estimated the fiscal impact of the disease, second we performed a cost–benefit analysis of the individual benefits of vaccination against the cost of the vaccine. To estimate the fiscal impact of the diseases, the human capital approach was used. Epidemiological data were extrapolated from the literature. A Monte Carlo simulation enabled exploration of the uncertainty in the model variables.

Results

For FLU, assuming 2.1 million people infected, the total expected impact was EUR 999,371,520; the estimated fiscal impact was EUR 159,563,520. For PC, assuming 90,000 people infected, the total impact was EUR 148,055,040 and the estimated fiscal impact was EUR 23,639,040. For HZ, assuming 6,400 people infected, the total impact was EUR 4,777,200, with EUR 630,000 resulting from a decrease in fiscal taxation.

Conclusions

In conclusion, our work shows how traditional methods aimed at estimating the cost of illness from a social perspective can be improved by additionally considering the fiscal impact, which accounts for the decrease in fiscal revenues due to illness.

Keywords

Fiscal impactSocial costProductivity lossVaccination strategy
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 2 , April 2020 , pp. 133 - 138
Copyright
Copyright © Cambridge University Press 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Towse, A, Barnsley, P (2013) Approaches to identifying, measuring, and aggregating elements of value. Int J Technol Assess Health Care. 29, 360–364.10.1017/S0266462313000524CrossRefGoogle ScholarPubMed
Vermeulen, KM, Krabbe, PFM (2018) Value judgment of health interventions from different perspectives: Arguments and criteria. Cost Eff Resour Alloc. 16, 16.CrossRefGoogle ScholarPubMed
Bloom, DE, Brenzel, L, Cadarette, D, Sullivan, J (2017) Moving beyond traditional valuation of vaccination: Needs and opportunities. Vaccine. 35, A29–A35.CrossRefGoogle ScholarPubMed
Bloom, DE, Fan, VY, Sevilla, JP (2018) The broad socioeconomic benefits of vaccination. Sci Transl Med. 10, 441.CrossRefGoogle ScholarPubMed
Brouwer, WB, Koopmanschap, MA, Rutten, FF (1997) Productivity costs in cost-effectiveness analysis: Numerator or denominator: A further discussion. Health Econ. 6, 511–514.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Zhang, W, Bansback, N, Anis, AH (2011) Measuring and valuing productivity loss due to poor health: A critical review. Soc Sci Med. 72, 185–192.CrossRefGoogle ScholarPubMed
Olsen, JA (1994) Production gains: Should they count in health care evaluations? Scot J Polit Econ. 41, 69–84.CrossRefGoogle Scholar
Koopmanschap, MA, Rutten, FF (1996) The consequence of production loss or increased costs of production. Med Care. 34, DS59–DS68.Google ScholarPubMed
Drummond, MF (2005) Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press.Google Scholar
Johannesson, M (1996) The willingness to pay for health changes, the human-capital approach and the external costs. Health Policy. 36, 231–244.CrossRefGoogle ScholarPubMed
Osservatorio Statistico dei Consulenti del Lavoro (2018) Le dinamiche del mercato del lavoro nelle province italiane. Available at: http://www.ipsoa.it/~/media/Quotidiano/2018/06/30/le-dinamiche-del-lavoro-in-italia-dati-e-prospettive-dal-festival-del-lavoro/cs_occup_fest%20pdf.pdf. Accessed 22 July 2018.Google Scholar
Ministero dell'Economia e delle Finanze (2018) Dichiarazioni dei redditi persone fisiche (Irpef) per l'anno di imposta 2016. Available at: https://www1.finanze.gov.it/finanze3/pagina_dichiarazioni/dichiarazioni.php. Accessed 22 July 2018.Google Scholar
Solow, R (1956) A contribution to the theory of economic growth. Q J Econ. 70, 65–94.CrossRefGoogle Scholar
ISTAT (2017) Annuario Statistico Italiano. Available at: https://www.istat.it/it/archivio/213021. Accessed 22 July 2018.Google Scholar
INPS (2019) Open Data. Available at: https://www.inps.it. Accessed 22 July 2018.Google Scholar
Bauer, TT, Welte, T, Ernen, C et al. . (2005) Cost analyses of community-acquired pneumonia from the hospital perspective. Chest. 128, 2238–2246.CrossRefGoogle ScholarPubMed
Siemieniuk, R, Gregson, DB, Gill, MJ (2011) The persisting burden of invasive pneumococcal disease in HIV patients: An observational cohort study. BMC Infect Dis. 11, 314.CrossRefGoogle ScholarPubMed
Personne, V, Chevalier, J, Buffel du Vaure, C et al. . (2016) CAPECO: Cost evaluation of community acquired pneumonia managed in primary care. Vaccine. 34, 2275–2280.CrossRefGoogle ScholarPubMed
Panatto, D, Bragazzi, NL, Rizzitelli, E et al. . (2015) Evaluation of the economic burden of herpes zoster (HZ) infection. Hum Vaccin Immunother. 11, 245–262.CrossRefGoogle ScholarPubMed
McLaughlin, JM, McGinnis, JJ, Tan, L, Mercatante, A, Fortuna, J (2015) Estimated human and economic burden of four major adult vaccine-preventable diseases in the United States, 2013. J Prim Prev. 36, 259–273.CrossRefGoogle ScholarPubMed
Istituto Superiore di Sanità (2018) Epicentro. Available at: https://www.epicentro.iss.it. Accessed 22 July 2018.Google Scholar
Gialloreti, LE, Merito, M, Pezzotti, P et al. . (2010) Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: A retrospective, population- based study. BMC Infect Dis. 10, 230.CrossRefGoogle ScholarPubMed
Sterrantino, C, Trifirò, G, Lapi, F et al. . (2013) Burden of community-acquired pneumonia in Italian general practice. Eur Respir J. 42, 1739–1742.10.1183/09031936.00128713CrossRefGoogle ScholarPubMed
Alicino, C, Trucchi, C, Paganino, C et al. . (2017) Incidence of herpes zoster and post-herpetic neuralgia in Italy: Results from a 3-years population-based study. Hum Vaccin Immunother. 13, 399–404.CrossRefGoogle ScholarPubMed
Cicchetti, A., Ruggeri, M, Mennini, FS, Gitto, L.(2010) Extending FLU vaccination to individuals aged 50–64 in four EU countries. Social savings and budget impact analysis. Int J Technol Assess Health Care. 26, 288–293.CrossRefGoogle Scholar
Supplementary material: File

Ruggeri et al. Supplementary Materials

Ruggeri et al. Supplementary Materials 1

Download Ruggeri et al. Supplementary Materials(File)
File 25.7 KB
Supplementary material: File

Ruggeri et al. Supplementary Materials

Ruggeri et al. Supplementary Materials 2

Download Ruggeri et al. Supplementary Materials(File)
File 25 KB
Supplementary material: File

Ruggeri et al. Supplementary Materials

Ruggeri et al. Supplementary Materials 3

Download Ruggeri et al. Supplementary Materials(File)
File 24.4 KB