Comparative analysis on the multi-agent co-payment financing mechanism of four doses of children's PCV13 in Weifang city, China

Abstract

Abstract Background Pneumococcal diseases cause severe burden in Chinese children, and vaccination is the most cost-effective intervention. However, pneumococcal conjugate vaccine (PCV) is not included in the national immunization program in China, which is paid out-of-pocketand expensive, leading to low vaccination coverage. Weifang City in Shandong Province has implemented a new vaccination strategy that provides free vaccination of any one dose of domestic PCV13 for registered children aged 6 months-2 years, providing an opportunity to develop a reasonable financing mechanism and improve the vaccination rate. Methods We collected data on the population of children and PCV13 vaccination rates in each vaccination clinic of Weifang in 2021 using the immunization planning system. Information on the sharing ratio of each funding channel and the procurement price of PCV13 was determined through government documents, questionnaires on parents' willingness and ability to pay, and expert interviews. The study calculated financing costs under different scenarios and the cost borne by each financing channel. ResultsThree financing strategies are proposed for the four doses of PCV13: "individual - commercial insurance - central and local finance co-payment ", "commercial insurance - central and local finance co-payment " and "commercial insurance and local finance co-payment". We calculated and compared the share amount of the total financing cost in each financing channel for each strategy. The Weifang government could bear the local financial expenses under strategies I and II when the domestic PCV13 purchase price is CNY652. To improve the vaccine coverage, out-of-pocket payments should be included in the financing channel, and the purchase price could be reduced. Individuals will not need to pay out-of-pocket when the purchase price is CNY465.4. Conclusions The cost of four doses of PCV13 inoculation for children in Weifang is high. We suggest focusing on individual, medical insurance, and commercial insurance aspects to optimize the multi-agent co-payment financing mechanism. Centralizing the purchasing process can reduce the purchase price of PCV13, aiming to increase vaccination coverage. Our findings provide insights for policymakers seeking to improve PCV coverage while reducing the cost of vaccination.