Vaccination planning and vaccine prices in a decentralizing country – Italy

Abstract

This paper gives an overview, in the era of regionalization, of vaccination planning and vaccine price management in the Italian National Health Service. In particular, we analyse the current National Vaccination Plan (NVP) and end with two “case studies” of the latest entries in the Italian vaccination calendar, comparing HPV and PCV vaccines, the most expensive ones in Italy at present. The present NVP put an end to the long period without official documents for vaccination planning, mainly reflecting the controversial relationships between the national and regional tiers. However, this document is not really useful for planning from the health professionals’ point of view, lacking epidemiological information. Thorough systematic assessment of the new, expensive vaccines is becoming a real priority in the light of current financial difficulties. In this perspective, the two examples discussed have given different results so far, starting from a heterogeneous situation of potential market competition.

Keywords::

• cost
• Italy
• policy
• tender
• vaccine

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• The present national vaccination plan is not really useful for planning from the health professionals’ point of view, lacking epidemiological information.

• Regionalization seems to have affected slightly only the set of vaccinations administered throughout the country so far.

• Devolution might have somewhat weakened the leading role historically played by central authorities.

• The total public expenditure for vaccines is still very low in Italy.

• The two very expensive vaccines recently introduced on the Italian market (human papilloma virus and pneumococcal conjugate vaccines) have given different results.

• Regional tenders for the two human papilloma virus vaccines have been very successful in making this vaccination sustainable.

• Only one vaccine has been adopted for pneumococcal vaccination in practice.

• Considerable savings can be achieved through regional tenders in Italy, once bids are designed in such a way that competition can produce its effects.

• The choice of the regional tier does not seem to raise the risk of market failure for vaccines in a big country like Italy.

Notes