Economic evaluations of Haemophilus influenzae type b (Hib) vaccine: a systematic review

Figures & data

Figure 1. A PRISMA flow diagram describing the study selection process.

Table 1. General characteristics of included studies.

Reference	Published year	Studied year	Affiliations of the first author	Country of the first author	Countries of study	Regions	Income groups	Funding
Akumu et al.^28	2007	2004	Kenya Medical Research Institute	Kenya	Kenya	Sub-Saharan Africa	LMICs	1. Kenya Medical Research Institute 2. WHO
Broughton^29	2007	2005	Columbia University	US	Indonesia	East Asia and Pacific	LMICs	—
Clark et al.^30	2013	2010	Department of health services research and policy, London School of Hygiene and Tropical Medicine	UK	India	South Asia	LMICs	1. GSK 2. Merck 3. Pfizer 4. GAVI Alliance
Duke^39	2002	2002	Gorona Hospital	Papua New Guinea	Papua New Guinea	East Asia and Pacific	LICs	—
Gargano et al.^38	2015	2013	Centers for Disease Control and Prevention	US	Somalia	Sub-Saharan Africa	LICs	—
Garpenholt et al.^27	1998	1995	Linkoping University	Sweden	Sweden	Europe and Central Asia	HICs	1. The Research Committee of the Orebro Country Council 2. Pasteur Merieux/MSD, Copenhagen
Gessner et al.^31	2008	2007	Agence de Medecine Preventive, France	Indonesia	Indonesia	East Asia and Pacific	LMICs	1. The office of Health and Nutrition, USA 2. SanofiPasteur, France
Ginsberg et al.^17	1993	1991	University-Hadassah School of Public Health	Israel	Israel	Middle East and North Africa	HICs	The neighborhood family health centers
Griffiths et al.^40	2011	2009	Hib Initiative, London School of Hygiene and Tropical Medicine	UK	1. Uzbekistan 2. Belarus	Europe and Central Asia	1. LMICs 2. UMICs	WHO
Griffiths et al.^9	2013	2010	London school of hygiene and tropical medicine	UK	Country groups 1. GAVI (Africa) 2. GAVI (Asia) 3. LMICs 4. UMICs	Multi-region	1. LICs 2. LMICs 3. UMICs	The GAVI alliance
Gupta et al.^32	2013	2009	School of Public Health, Post Graduate Institute of Medical Education and Research	India	India	South Asia	LMICs	—
Harris et al.^18	1994	1990	Department of Public Health, The University of Western Australia	Australia	Australia	East Asia and Pacific	HICs	MSD, Australia
Hay and Daum^19	1987	1984	Stanford University	US	US	North America	HICs	Rescon, Inc
Hay and Daum^20	1990	1988	Stanford University	US	US	North America	HICs	Connaught laboratories, Inc.
Hussey et al.^35	1995	1992	University of Cape Town	South Africa	South Africa	Sub-Saharan Africa	UMICs	1. Medical Research Council 2. Lederle Laboratories
Le et al.^33	2015	2013	University of Texas School of Public Health	US	Vietnam	East Asia and Pacific	LMICs	The GAVI alliance
Limcangco et al.^34	2001	1998	College of Pharmacy, University of the Philippines	Philippines	Philippines	East Asia	LMICs	—
Livartowski et al.^21	1996	1993	Departement de pediatric, Faculte de medecine, Universite Paris	France	France	Europe and Central Asia	HICs	French government
McIntyre et al.^22	1994	1991	Department of Pediatrics, Westmead Hospital	Australia	Australia	East Asia and Pacific	HICs	Department of Health, Housing and Community Services, and the Epidemiology and Health Services Evaluation Branch of the New South Wales
Moradi-Lakeh et al.^36	2012	2008	Tehran University of Medical Sciences	Iran	Iran	Middle East and North Africa	UMICs	Iran University of Medical Sciences
Muangchan and Warinsatian^37	2011	2006	National Vaccine Committee Office, Department of Disease Control, Ministry of Public Health	Thailand	Thailand	East Asia and Pacific	UMICs	—
Niessen et al.^41	2009	2005	Department of International Health, Johns Hopkins Bloomberg School of Public Health	US	WHO country regions 1. African 2. Americas 3. Eastern Mediterranean 4. South-East Asia 5. Western Pacific	Multi-region	1. LICs 2. LMICs 3. UMICs 4. HICs	1. Netherland Environmental Assessment Agency 2. WHO 3. The United Nations Children’s Fund
Platonov et al.^23	2006	2001	Central Institute of Epidemiology, Russian Federation	Russia	Russia	Europe and Central Asia	HICs	WHO
Pokorn et al.^24	2001	1999	University Medical Center Ljubljana	Slovenia	Slovenia	Europe and Central Asia	HICs	—
Shin et al.^8	2008	2003	Seoul National University, School of Public Health	Korea	Korea	East Asia and Pacific	HICs	WHO
Trollfors^25	1994	1993	University of Goteborg	Sweden	Sweden	Europe and Central Asia	HICs	—
Zhou et al.^26	2002	2000	US Department of Health and Human Services	US	US	North America	HICs	—

Abbreviations. GAVI, Global Alliance for Vaccines and Immunization; GSK, GlaxoSmithKline; HICs, High-Income Countries; LICs, Low-Income Countries; LMICs, Lower Middle-Income Countries; MSD, Merck Sharp and Dohme; UMICs, Upper Middle-Income Countries; UK, United Kingdom; US, United States; WHO; World Health Organization.

Table 2. Economic evaluation-related characteristics of included studies.

References	Target vaccinated populations	Interventions	Comparators	Study types	Perspectives	Time horizons	Discount rates	Thresholds	Sensitivity analyses
Akumu et al.^28	Children <5 years	Combined vaccination (DTP-Hib-HB)	Without Hib vaccination (DTP-HB)	1. CEA 2. CUA	Healthcare payer	Lifetime	1. Cost 3% 2. Benefit 3%	1 time of GDP	One-way
Broughton^29	Children <1 year	Combined vaccination (DTP-Hib-HB)	Without Hib vaccination (DTP-HB)	1. CBA 2. CUA	Societal	Lifetime	1. Cost 3% 2. Benefit 3%	—	1. One-way 2. Two-way
Clark et al.^30	Children <5 years	Single Hib vaccination	Without vaccination	CUA	1. Societal 2. Healthcare payer	Lifetime	1. Cost 3% 2. Benefit 3%	1–3 times of GDP	One-way
Duke^39	—	1. Single Hib vaccination 2. Single Hib vaccination	1. Chloramphenicol 2. Ceftriaxone	CEA	Societal	Lifetime	1. Cost 5% 2. Benefit 5%	—	One-way
Gargano et al.^38	Children <2 years	1. Single Hib vaccination 2. Combined vaccination (Hib-PCV10)	Without vaccination	1. CEA 2. CUA	Healthcare payer	Lifetime	—	1–3 times of GDP	One-way
Garpenholt et al.^27	Children <5 years	Single Hib vaccination	Without vaccination	CBA	Societal	Lifetime	1. Cost 5% 2. Benefit 5%	—	One-way
Gessner et al.^31	Children <2 years	1. Single Hib vaccination 2. Combined vaccination (DTP-Hib-HB)	Without vaccination	1. CBA 2. CEA 3. CUA	1. Societal 2. Healthcare payer	Lifetime	1. Cost 3% 2. Benefit 3%	1 time of GNI	One-way
Ginsberg et al.^17	Children <5 years	Single Hib vaccination	Without vaccination	1. CBA 2. CEA	Societal	Lifetime	1. Cost 5% 2. Benefit 5%	—	—
Griffiths et al.^40	Children <5 years	Single Hib vaccination	Without vaccination	1. CBA 2. CUA	Societal	Lifetime	1. Cost 3% 2. Benefit 3%	1–3 times of GDP	One-way
Griffiths et al.^9	Children <5 years	Combined vaccination (DTP-HB-Hib)	Without Hib vaccination (DTP-HB)	CUA	1. Societal 2. Healthcare payer	Lifetime	1. Cost 3% 2. Benefit 3%	1 time of GNI	PSA
Gupta et al.^32	Children <5 years	Combined vaccination (DTP-Hib-HB)	Without Hib vaccination (DTP-HB)	1. CEA 2. CUA	1. Societal 2. Healthcare payer	Lifetime	Cost 3%	3 times of GDP	One-way
Harris et al.^18	Children <1 year	Single Hib vaccination	Without vaccination	1. CEA 2. CUA	1. Healthcare payer 2. Others^a	Lifetime	1. Cost 5% 2. Benefit 5%	1 time of GDP	One-way
Hay and Daum^19	1. Children at 18 months 2. Children at 24 months	1. Single Hib vaccination 2. Combined vaccination	Without vaccination	CBA	Societal	60 years	1. Cost 3% 2. Benefit 3%	—	One-way
Hay and Daum^20	1. Children at 18 months 2. Children at 24 months	1. Single Hib vaccination 2. Combined vaccination	Without vaccination	CBA	Societal	60 years	1. Cost 3% 2. Benefit 3%	—	One-way
Hussey et al.^35	Children <1 year	Combined vaccination (DTP-Hib)	Without Hib vaccination (DTP)	CBA	Societal	Lifetime	1. Cost 2% 2. Benefit 2%	—	One-way
Le et al.^33	Children <5 years	Combined vaccination (DTP-Hib-HB)	Without Hib vaccination (DTP-HB)	1. CEA 2. CUA	1. Societal 2. Healthcare payer	Lifetime	1. Cost 6.9% 2. Benefit 5%	3 times of GDP	1. One-way 2. PSA
Limcangco et al.^34	Children <1 year	Combined vaccination (DTP-Hib)	Without Hib vaccination (DTP)	CBA	1. Societal 2. Healthcare payer	Lifetime	Cost 5%	—	One-way
Livartowski et al.^21	Children <1 year	Combined vaccination (DTP-Hib)	Without Hib vaccination (DTP)	1. CBA 2. CUA	1. Healthcare payer 2. Others^a	Lifetime	1. Cost 6% 2. Benefit 6%	—	One-way
McIntyre et al.^22	1. Children <6 months 2. Children <12 months 3. Children <18 months	Combined vaccination (DTP-Hib)	Without vaccination	1. CEA 2. CUA	Other^a	Lifetime	1. Cost 5% 2. Benefit 5%	—	One-way
Moradi-Lakeh et al.^36	Children <1 year	Combined vaccination (DTP-Hib)	Without Hib vaccination (DTP)	1. CBA 2. CEA 3. CUA	Societal	Lifetime	1. Cost 3% 2. Benefit 3%	3 times of GDP	1. One-way 2. Two-way
Muangchana and Warinsatian^37	Children <5 years	Combined vaccination (DTP-Hib)	Without Hib vaccination (DTP)	CBA	Societal	Lifetime	1. Cost 3% 2. Benefit 3%	—	1. One-way 2. Multi-way
Niessen et al.^41	Children <5 years	Combined vaccination (DTP-Hib-HB)	Without Hib vaccination (DTP-HB)	CUA	Healthcare payer	10 years	Cost 3%	—	—
Platonov et al.^23	Children <5 years	Combined vaccination (DTP-Hib)	Without Hib vaccination (DTP)	1. CBA 2. CEA 3. CUA	Societal	Lifetime	Cost 3%	3 times of GDP	1. One-way 2. PSA
Pokorn et al.^24	Children <1 year	Single Hib vaccination	Without vaccination	CBA	1. Societal 2. Healthcare payer	Lifetime	1. Cost 5% 2. Benefit 5%	—	One-way
Shin et al.^8	Children <1 year	Single Hib vaccination	Without vaccination	CBA	Societal	Lifetime	1. Cost 5% 2. Benefit 5%	—	One-way
Trollfors^25	Children <1 year	Single Hib vaccination	Without vaccination	CBA	Societal	Lifetime	—	—	—
Zhou et al.^26	Children <1 year	Combined vaccination (DTP-Hib)	Without vaccination	1. CBA 2. CEA 3. CUA	1. Societal 2. Other^a	50 years	1. Cost 3% 2. Benefit 3%	—	One-way

Abbreviations. CBA, Cost-Benefit Analysis; CEA, Cost-Effectiveness Analysis; CUA, Cost-Utility Analysis; DALY, Disability-adjusted life year; DTP, Diphtheria-Tetanus-Pertussis; GDP, Gross Domestic Product; GNI, Gross National Income; HB, Hepatitis B; Hib, Haemophilus influenzae type b; PCV7, 7-valent Pneumococcal Conjugated Vaccine; PSA, Probabilistic Sensitivity Analysis; QALY, Quality-adjusted life year.

^a Other perspective was divided into two definitions: (1) direct cost perspective including direct medical and direct non-medical costs in the analysis was used in three studies^18,22,26; and (2) Patients’ families perspective (co-payments) was used in one study²¹.

Table 3. Results of benefit/cost ratios and net savings from cost-benefit analysis studies.

Reference (year)	Benefit/cost ratios	Net savings (USD)	Results
Hay and Daum^19 (1987)
Single Hib vaccination
UV	2.04	129,836,430	Cost-saving
UV18	1.09	12,251,550
Combined vaccination
UV + RH	2.92	243,672,710
UV + RH + RD	2.90	253,495,990
UV + RD	2.06	139,657,710
UV + DC + RD + RH	1.91	202,648,530
UV + DC + RH	1.89	192,975,510
UV + DC + RD	1.41	90,200,700
UV + DC	1.37	80,527,680
Hay and Daum^20 (1990)
Single Hib vaccination
PRP	1.20	32,693,520	Cost-saving
Combined vaccination
(PRP-D or HbOC)+RH	4.41	557,013,990
(PRP-D or HbOC)+RH + RD	4.32	569,281,580
(PRP-D or HbOC)+RD	3.53	427,237,670
PRP + RH + RD	2.16	198,471,180
PRP + RH	2.14	185,087,640
PRP + RD	1.27	46,077,070
Ginsberg et al.^17 (1993)
Single Hib vaccination
3-dose schedule	1.26	8,592,851.21	Cost-saving
4-dose schedule	1.45	8,947,447.44
Trollfors^25 (1994)	—	—	Cost-saving
Hussey et al.^35 (1995)
Human capital approach	1.29	1,496,957.90	Cost-saving
Subsistence/human capital approach	1.43	2,187,617.31
Livartowski et al.^21 (1996)
Healthcare payer perspective	—	3,041,929,410	Cost-saving
Other perspective^b	—	274,370,104
Garpenholt et al.^27 (1998)	—	28,526,027.1	Cost-saving
Limcangco et al.^34 (2001)
Healthcare payer perspective	—	1,386,778.16	Cost-saving
Societal perspective	—	9,067,395.73
Pokorn et al.^24 (2001)
Healthcare payer perspective	0.99	12,001.08	Cost-saving
Societal perspective	1.39	–196,548.94	Not-cost saving
Zhou et al.^26 (2002)
Societal perspective	5.3	2,874,656,340	Cost-saving
Other perspective^b	3.4	1,308,102,630
Platonov et al.^23 (2006)	0.06	–1,870,033.35	Not cost-saving
Broughton^29 (2007)
UNICEF Price	—	10,995,258.68	Cost-saving
GAVI Price	—	4,490,337.43
Gessner et al.^31 (2008)
Healthcare payer perspective
Combined vaccination (DTP-Hib-HB)	—	19,433,057.5	Cost-saving
Single Hib vaccination	—	768,659.73
Societal perspective
Combined vaccination (DTP-Hib-HB)	—	27,320,592.5
Single Hib vaccination	—	—
Shin et al.^8 (2008)	0.77	–8,616,584.69	Not cost-saving
Muangchana and Warinsatian^37 (2011)	—	79,946,210.3	Cost-saving^a
Griffiths et al.^40 (2011)
Belarus	—	—	Cost-saving
Uzbekistan	—	6,827,563.82
Moradi-Lakeh et al.^36 (2012)	2.14	9,897,926.49	Cost-saving

Abbreviations. DC, Vaccination of all day-care attendees; DTP, Diphtheria-Tetanus-Pertussis; GAVI, Global Alliance for Vaccines and Immunization; HB, Hepatitis B; HbOC, Haemophilus influenzae type b oligosaccharide-mutant diphtheria toxin conjugate vaccine; Hib, Haemophilus influenzae type b; PRP, Haemophilus influenzae type b polysaccharide vaccine; PRP-D, Haemophilus influenzae type b polysaccharide-diphtheria toxoid conjugate vaccine; RD, Rifampin prophylaxis of appropriate day-care contacts; RH, Rifampin prophylaxis of appropriate household contacts; UNICEF, United Nations Children's Emergency Fund; USD, United States Dollar; UV, 24-month Universal vaccination; UV18, 18-month Universal vaccination.

Net savings were inflated to USD value at the year 2015 using the USD Consumer price index (CPI) for all urban consumers (CPI-U).

^a Hib vaccination program was cost-effective only if intangible benefits, i.e. avoiding the pain and suffering caused by the disease, were incorporated in the model analysis.

^b Other perspective was divided into two definitions: (1) direct cost perspective including direct medical and direct non-medical costs in the analysis was used in three studies^18,22,26; (2) Patients‘families perspective (co-payments) was used in one study²¹.

Table 4. Incremental cost effectiveness ratios (cost per case averted, cost per death averted, and cost per life-year gained).

Reference (year)	Incremental cost effectiveness ratios, USD
	Cost per case averted	Cost per death averted	Cost per life-year gained
Ginsberg et al.^17 (1993)
Single Hib vaccination (4-dose schedule)	—	1,512,593.07	19,807.10
McIntyre et al.^22 (1994)
Combined Hib vaccination (DTP-Hib)
1-dose schedule	—	—	1,717.59
2-dose schedule	—	—	10,519.59
3-dose schedule	—	—	9,451.10
Livartowski et al.^21 (1996)
Payer perspective	—	—	16,128.64
Other perspective^a	—	—	30,642.36
Duke^39 (2002)	—	1,602.07	—
Platonov et al.^23 (2006)	91,118.69 ± 18,844.97	888,442.24 ± 308,005.71	—
Akumu et al.^28 (2007)	336.27	1,501.90	—
Gessner et al.^31 (2008)
Societal perspective
Combined vaccination	—	3,648.84	—
Single Hib vaccination	—	5,073.17	—
Moradi-Lakeh et al.^36 (2012)	7,435.16	86,828.70	—
Gupta et al.^32 (2013)
Healthcare payer perspective	43.09	9,732.04	331.44
Societal perspective	127.05	28,728.80	977.73
Gargano et al.^38 (2015)
Single Hib vaccination
Hib (one-dose schedule)	670.26	7,130.44	—
Hib (two-dose schedule)	986.54	10,945.98	—
Combined vaccination
Hib with PCV10 (one-dose schedule)	445.64	4,740.86	—
Hib with PCV10 (two-dose schedule)	740.98	4,740.86	—
Le et al.^33 (2015)
Healthcare payer perspective	6,954	29,449	—
Societal perspective	6,252	26,476	—

All costs were presented in United States Dollars (USD), and were inflated to the value at 2015 using the USD Consumer price index (CPI) for all urban

consumers (CPI-U).

Abbreviations. Hib, Haemophilus influenzae type b; PCV10, 10-valent Pneumococcal Conjugated Vaccine; USD, United States Dollar.

^a Other perspective was defined as: (1) direct cost perspective including direct medical and direct non-medical costs in the analysis was used in three studies²²; (2) Patients‘families perspective (co-payments) was used in one study²¹.

Table 5. Incremental cost-effectiveness ratios (cost per QALY gained).

Reference (year)	Cost per QALY gained, USD
Harris et al.^18 (1994)
Healthcare payer perspective	242,728.45
Other perspective^a	6,462.06
McIntyre et al.^22 (1994)
Combined Hib vaccination (DTP-Hib)
1-dose schedule	2,142.20
2-dose schedule	15,898.59
3-dose schedule	12,059.68
Livartowski et al.^21 (1996)
Payer perspective	10,154.83
Other perspective^a	19,291.79
Zhou et al.^26 (2002)
Societal perspective	6,536.00
Other perspective^a	8,000.44

All cost were presented in United States Dollars (USD), and were inflated to the value at 2015 using the Consumer price index (CPI) for all urban consumers (CPI-U).

Abbreviations. Hib, Haemophilus influenzae type b; QALY, Quality-adjusted life year; USD, United States Dollar.

^a Other perspective was defined as: (1) direct cost perspective including direct medical and direct non-medical costs in the analysis was used in three studies^18,22,26; (2) Patients‘ families perspective (co-payments) was used in one study²¹.

Table 6. Incremental cost-effectiveness ratios (cost per DALY averted).

Reference (year)	Cost per DALY averted, USD
Platonov et al.^23 (2006)	14,510.10 ± 3,869.09
Akumu et al.^28 (2007)	47.68
Broughton^29 (2007)	98.68
Gessner et al.^31 (2008)
Societal perspective
Combined vaccination	84.59
Single Hib vaccination	116.60
Niessen et al.^41 (2009)
Low scenario estimate
SEAR B	192.96
SEAR D	288.84
WPR B	139.56
AFR D	32.77
AFR E	55.83
EMR D	42.48
AMR D	116.51
AMR B	157.77
High scenario estimate
SEAR B	493.94
SEAR D	355.59
WPR B	740.30
AFR D	83.74
AFR E	145.63
EMR D	108.01
AMR D	297.33
AMR B	406.56
Moradi-Lakeh et al.^36 (2012)	5,495.87
Gupta et al.^32 (2013)
Healthcare payer perspective	904.82
Societal perspective	306.03
Clark et al.^30 (2013)
Healthcare payer perspective	410.87
Societal perspective	359.78
Griffiths et al.^9 (2013)
Healthcare payer perspective
GAVI (Africa)	27.17
GAVI (Asia)	38.04
LMICs	119.57
UMICs	492.39
Societal perspective
GAVI (Africa)	Cost-saving
GAVI (Asia)	10.87
LMICs	98.91
UMICs	401.09
Gargano et al.^38 (2015)	—
Single Hib vaccination	140.27
Hib (one-dose schedule)	206.47
Hib (two-dose schedule)
Combined vaccination
Hib with PCV10 (one-dose schedule)	93.27
Hib with PCV10 (two-dose schedule)	155.08
Le et al.^33 (2015)
Healthcare payer perspective	1,393.88
Societal perspective	1,252.45

All cost were presented in United States Dollars (USD), and were inflated to the value at year 2015 using the Consumer price index (CPI) for all urban consumers (CPI-U).

Abbreviations. AFR, WHO African Region; AMR, WHO Region of the Americas; EMR, WHO Eastern Mediterranean Region; SEAR, WHO South-East Asia Region; WPR, WHO Western; WHO regions were subdivided based on child and adult mortality:

A, very low child and very low adult mortality; B, low child and low adult mortality; C, low child and high adult mortality; D, high child and high adult mortality; E, high child and very high adult mortality. DALY, Disability-adjusted life year; GAVI, Global Alliance for Vaccines and Immunization; Hib, Haemophilus influenzae type b; LMICs, Lower Middle-Income Countries; PCV10, 10-valent Pneumococcal Conjugated Vaccine; UMICs, Upper Middle-Income Countries; USD, United States Dollars.

Akumu AO, English M, Scott JA, et al. Economic evaluation of delivering Haemophilus influenzae type b vaccine in routine immunization services in Kenya. Bull WHO 2007;85:511-18

 PubMed Web of Science ®Google Scholar

Broughton EI. Economic evaluation of Haemophilus influenzae type B vaccination in Indonesia: a cost-effectiveness analysis. J Public Health (Oxf) 2007;29:441-8

 PubMed Web of Science ®Google Scholar

Clark AD, Griffiths UK, Abbas SS, et al. Impact and cost-effectiveness of Haemophilus influenzae type b conjugate vaccination in India. J Pediatr 2013;163(1 Suppl):S60-S72

 PubMed Web of Science ®Google Scholar

Duke T. Haemophilus influenzae type b meningitis: how much better is prevention than cure? P N G Med J 2002;45:213-18

 PubMedGoogle Scholar

Gargano LM, Hajjeh R, Cookson ST. Pneumonia prevention during a humanitarian emergency: cost-effectiveness of Haemophilus influenzae type B conjugate vaccine and pneumococcal conjugate vaccine in Somalia. Prehosp Disaster Med 2015;30:402-11

 PubMed Web of Science ®Google Scholar

Garpenholt O, Silfverdal SA, Levin LA. Economic evaluation of general childhood vaccination against Haemophilus influenzae type b in Sweden. Scand J Infect Dis 1998;30:5-10

 PubMed Web of Science ®Google Scholar

Gessner BD, Sedyaningsih ER, Griffiths UK, et al. Vaccine-preventable Haemophilus influenza type B disease burden and cost-effectiveness of infant vaccination in Indonesia. Pediat Infect Dis J 2008;27:438-43

 PubMed Web of Science ®Google Scholar

Ginsberg GM, Kassis I, Dagan R. Cost benefit analysis of Haemophilus influenzae type b vaccination programme in Israel. J Epidemiol Community Health 1993;47:485-90

 PubMed Web of Science ®Google Scholar

Griffiths UK, Clark A, Shimanovich V, et al. Comparative economic evaluation of Haemophilus influenzae type b vaccination in Belarus and Uzbekistan. PLoS One 2011;6:e21472

 PubMed Web of Science ®Google Scholar

Griffiths UK, Clark A, Hajjeh R. Cost-effectiveness of Haemophilus influenzae type b conjugate vaccine in low- and middle-income countries: Regional analysis and assessment of major determinants. J Pediat 2013;163(1Suppl):S50-S59

 Web of Science ®Google Scholar

Gupta M, Prinja S, Kumar R, et al. Cost-effectiveness of Haemophilus influenzae type b (Hib) vaccine introduction in the universal immunization schedule in Haryana State, India. Health Policy Plan 2013;28:51-61

 PubMed Web of Science ®Google Scholar

Harris A, Hendrie D, Bower C, et al. The burden of Haemophilus influenzae type b disease in Australia and an economic appraisal of the vaccine PRP-OMP. Med J Aust 1994;160:483-8

 PubMed Web of Science ®Google Scholar

Hay JW, Daum RS. Cost-benefit analysis of two strategies for prevention of Haemophilus influenzae type b infection. Pediatrics 1987;80:319-29

 PubMed Web of Science ®Google Scholar

Hay JW, Daum RS. Cost-benefit analysis of Haemophilus influenzae type b prevention: conjugate vaccination at eighteen months of age. Pediat Infect Dis J 1990;9:246-52

 PubMed Web of Science ®Google Scholar

Hussey GD, Lesser ML, Reekie WD. The costs and benefits of a vaccination programme for Haemophilus influenzae type B disease. S Afr Med J 1995;85:20-5

 PubMed Web of Science ®Google Scholar

Le P, Griffiths UK, Anh DD, et al. Cost-effectiveness of Haemophilus influenzae type b vaccine in Vietnam. Vaccine 2015;33:4639-46

 PubMed Web of Science ®Google Scholar

Limcangco MR, Armour CL, Salole EG, et al. Cost-benefit analysis of a Haemophilus influenzae type b meningitis prevention programme in The Philippines. Pharmacoeconomics 2001;19:391-400

 PubMed Web of Science ®Google Scholar

Livartowski A, Boucher J, Detournay B, et al. Cost-effectiveness evaluation of vaccination against Haemophilus influenzae invasive diseases in France. Vaccine 1996;14:495-500

 PubMed Web of Science ®Google Scholar

McIntyre P, Hall J, Leeder S. An economic analysis of alternatives for childhood immunisation against Haemophilus influenzae type b disease. Aust J Public Health 1994;18:394-400

 PubMedGoogle Scholar

Moradi-Lakeh M, Shakerian S, Esteghamati A. Immunization against Haemophilus influenzae Type b in Iran; cost-utility and cost-benefit analyses. Int J Prev Med 2012;3:332-40

 PubMedGoogle Scholar

Muangchana C, Warinsatian P. Incorporation of private demand into cost-benefit analysis of a universal Hib vaccination program in Thailand. SE Asian J Trop Med Public Health 2011;42:376-87

 PubMed Web of Science ®Google Scholar

Niessen LW, ten Hove A, Hilderink H, et al. Comparative impact assessment of child pneumonia interventions. Bull WHO 2009;87:472-80

 PubMed Web of Science ®Google Scholar

Platonov AE, Griffiths UK, Voeykova MV, et al. Economic evaluation of Haemophilus influenzae type b vaccination in Moscow, Russian Federation. Vaccine 2006;24:2367-76

 PubMed Web of Science ®Google Scholar

Pokorn M, Kopac S, Neubauer D, et al. Economic evaluation of Haemophilus influenzae type b vaccination in Slovenia. Vaccine 2001;19:3600-5

 PubMed Web of Science ®Google Scholar

Shin S, Shin YJ, Ki M. Cost-benefit analysis of Haemophilus influenzae type B immunization in Korea. J Kor Med Sci 2008;23:176-84

 PubMed Web of Science ®Google Scholar

Trollfors B. Cost-benefit analysis of general vaccination against Haemophilus influenzae type b in Sweden. Scand J Infect Dis 1994;26:611-14

 PubMed Web of Science ®Google Scholar

Zhou F, Bisgard KM, Yusuf HR, et al. Impact of universal Haemophilus influenzae type b vaccination starting at 2 months of age in the United States: an economic analysis. Pediatrics 2002;110:653-61

 PubMed Web of Science ®Google Scholar