The cost of vaccination throughout life: A western European overview

Figures & data

Table 1. Diseases prevented according to national vaccination calendars (2014 or 2015).

	Germany		England		France		Italy		Spain		Sweden		Portugal
	Healthy	UC	Healthy	UC	Healthy	UC	Healthy	UC	Healthy	UC	Healthy	UC	Healthy	UC
Diphtheria	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Tetanus	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Poliomyelitis	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Pertussis	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Hemophilius influenza B	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Influenza	✓^1	✓	✓^3	✓	✓^5	✓	✓^5	✓	✓^5	✓			✓^5	✓
Pneumococcal	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Meningococcal C	✓		✓	✓	✓	✓	✓	✓	✓	✓			✓	✓
Meningococcal ACWY		✓
Measle	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Mumps	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Rubella	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Varicella	✓	✓				✓		✓		✓
Hepatitis A		✓				✓		✓						✓
Hepatitis B	✓	✓		✓	✓	✓	✓	✓		✓		✓	✓	✓
Rotavirus	✓	✓	✓	✓
HPV^4	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓	✓
Zoster			✓^2	✓^2
Tuberculosis						✓						✓	✓	✓
Tick-borne encephalitis		✓

UC: individuals with underlying conditions;

¹ ≥60y only;

² 70y only;

³ 2–4y & ≥65y only;

⁴ Girls only;

⁵ ≥65y only

Figure 1. Maximal vaccination cost throughout life in Germany.

Figure 2. Maximal vaccination cost throughout life in England.

Figure 3. Maximal vaccination cost throughout life in France.

Figure 4. Maximal vaccination cost throughout life in Italy.

Figure 5. Maximal vaccination cost throughout life in Spain.

Figure 6. Maximal vaccination cost throughout life in Sweden.

Figure 7. Maximal vaccination cost throughout life in Portugal.

Table 2. Levels of pricing data and administration assumptions.

Country	Pricing data	Opportunistic vaccination		Co-administration
Germany	List price [37]	None	Cost of administration depending upon the number of vaccine valences	None
England	List price [38]	≤6 y ≥7and ≤64 y ≥65 y	One GP visit every 2 vaccinations One GP visit every vaccination +School program for HPV vaccination One GP visit every 2 vaccinations	Birth 2 m 3 m 4 m 12 m 3 y 14 y ≥18 y ≥65 y 70 y	BCG + HB ^* DTacP-IPV-Hib + Pneumo cj + Rotavirus DTacP-IPV-Hib + Mgo C cj + Rotavirus DTacP-IPV-Hib + Pneumo cj Hib-Mgo C cj + Pneumo cj DTacP-IPV + MMR Td-IPV + Mgo C cj TdacP-IPV + Influenza^* Pneumo ps + Influenza Herpes zoster + Influenza
France	List price [39]	≤6 y ≥7 and ≤64 y ≥65 y	One pediatrician visit every 2 vaccinations One GP visit every vaccination One GP visit every 2 vaccinations	Birth ≤12 m 12 m 6 y 11–13 y 11–13 y ≥7 y ≥65 y	BCG + HB^* DTacP-IPV-Hib-HB + Pneumo cj Mgo C cj + MMR DTacP-IPV + Influenza^* TdacP-IPV + HPV HPV + Influenza^* Td-IPV/TdacP-IPV + Influenza^* Td-IPV + Influenza
Italy	List price [40,44]	None	One GP visit every vaccination	≤12 m 12 m 5–6 y ≥65 y	DTacP-IPV-Hib-HB + Pneumo cj MMR + Mgo C cj DTacP-IPV + MMR Pneumo ps + Influenza^*
Spain	List price [41]	None	One GP visit every vaccination	2 m 4 m 6–12 m	TdacP-IPV-Hib + Pneumo cj TdacP-IPV-Hib + Pneumo cj TdacP-IPV-Hib + Pneumo cj
Sweden	List price [42]	None	One GP visit every vaccination +School program for HPV vaccination	≤12 m ≤12 m 14 y	DTacP-IPV-Hib + Pneumo cj DTacP-IPV-Hib + Pneumo cj+ HB^* TdaP + Influenza^*
Portugal	List price and publicly available maximum tender price [43]	None	One GP visit every vaccination	None

* For individuals with underlying conditions

BCG: Tuberculosis vaccine; DTacP-IPV-Hib: Diphtheria, tetanus, poliomyelitis, pertussis and hemophilus influenza type B vaccine; GP: General practitioner; HB: Hepatitis B vaccine; HPV: Human papillomavirus vaccine; Mgo C cj: Meningococcal disease C conjugate vaccine; MMR: Measles, mumps and rubella vaccine; Pneumo cj: Pneumococcal conjugate vaccine; Pneumo ps: Pneumococcal polysaccharide vaccine.

Table

Therapeutic class	Example of drugs	Treatment time	Dosing	Number of boxes	Price per box	Funding by NHI	Estimatedcost of treatment
Statin	Crestor® rosuvastatin 5 mg (box of 90)	25 y (60–85 y)	1/day	100	€49.64	65%	€ 3,227
Anti-hypertensive	Eupressyl®urapidil 60 mg (box of 30)	25 y (60–85 y)	2/day	600	€12.38	65%	€ 4,828
DPP-4 inhibitor	Januvia®sitagliptin 100 mg (box of 30)	20 y (65–85 y)	1/day	240	€44.00	65%	€ 6,864
Antithrombotic	Plavix®clopidogrel 75 mg (box of 30)	25 y (60–85 y)	1/day	300	€30.41	65%	€ 5,930
Bisphosphonate	Actonel® risedronate 75 mg (box of 6)	35 y (50–85 y)	1/month	70	€75.70	65%	€ 3,444

Source: ¹⁵ for prices per box and ³⁶ for life expectancy.