Immunization against Haemophilus Influenzae Type b in Iran; Cost-utility and Cost-benefit Analyses

Background: haemophilus influenzae type b (hib) is an importantcause of morbidity and mortality in children. although its burden isconsiderably preventable by vaccine, routine vaccination against hibhas not been defined in the national immunization program of iran.this study was performed to assess the cost-benefit and cost?utilityof running an hib vaccination program in iran.methods: based on a previous systematic review and meta?analysisfor vaccine efficacy, we estimated the averted dalys (disabilityadjusted life years) and cost?benefit of vaccination. different acuteinvasive forms of hib infection and the permanent sequels wereconsidered for estimating the attributed dalys. we used a societalperspective for economic evaluation and included both direct andindirect costs of alternative options about vaccination. an annualdiscount rate of 3% and standard age?weighting were used forestimation. to assess the robustness of the results, a sensitivityanalysis was performed.results: the incidence of hib infection was estimated 43.0 per100000, which can be reduced to 6.7 by vaccination. total costs ofvaccination were estimated at us$ 15,538,129. routine vaccinationof the 2008 birth cohort would prevent 4079 dalys at a cost peraverted?daly of us$ 4535. if we consider parents’ loss of incomeand future productivity loss of children, it would save us$ 8,991,141,with a benefit?cost ratio of 2.14 in the base?case analysis. sensitivityanalysis showed a range of 0.78 to 3.14 for benefit?to?cost ratios.conclusion: considering costs per averted daly, vaccinationagainst hib is a cost?effective health intervention in iran, andallocating resources for routine vaccination against hib seemslogical.