BUDGET IMPACT ANALYSIS (BIA) POLYSACCAHARIDE CAPSULAR VI TYPHOID IN INDONESIA

• Main Author: Dwi Astuti, Ginanjar
• Format: Theses
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/39726
• Institution: Institut Teknologi Bandung

Typhoid fever that is caused by Salmonella typhi has a substantial economic impact in developing countries, such as Indonesia. This situation might be caused by a relatively high treatment cost due to typoid fever, including direct cost (medical and non-medical), indirect cost and all costs covered by national health insurance (BPJS Kesehatan). Up to now, a lot of prevention strategies have been conducted. Yet, the prevalence of typhoid fever in Indonesia remains high. Vaccination is considered to be the most cost-effective intervention to prevent typhoid fever in several countries. By applying budget impact analysis (BIA), the purpose of this study was to identify the impact of polysaccharide capsular Vi typhoid vaccination on the routine immunization budget. A method of top-down cost analysis was applied in this study by collecting observed costs from various secondary data to estimate Incremental cost-effectiveness ratio (ICER) and to analyse the impact of this new immunization program in a time horizon of 2020 –2024 within two scenarios: introduction of typhoid vaccine in targeted regions based on disease burden without nationwide vaccination in 2024 and with nationwide vaccination in 2024. The results showed that vaccination can prevent the number of cases (outpatient and hospitalization) and the number of death in 2020 –2024 at consecutive values: 117 and 0; 1,741 and 4; 3,863 and 9; 24,538 and 5; 37,435 and 83 in a scenario without nationwide immunization in 2024 (scenario 1) and 905,821 and 201 in a scenario with nationwide vaccination in 2024 (scenario 2). Compared with routine immunization budget, total required budget for typhoid vaccination in 2020 –2024 would be 0.05%; 0.93%; 1.74%; 3.74% and 6.63% for scenario 1 and 28.89% for scenario 2 when nationwide vaccination would be implemented in 2024. From the calculation of ICER, typhoid vaccination in Indonesia can be concluded as a cost-effective intervention, compared with no vaccination since the required budget would be 28.89% of total routine immunization budget in Indonesia.