41 巻 (2010) 5 号 p. 245-252
A number of new vaccines for preventable diseases such as meningitis and cervical cancer are getting available for Japanese children. However, those vaccines are categorized as voluntary vaccination and their costs should be paid by recipients. Therefore, high cost is a barrier for access to the preventive care. In addition, subsidiary by local governments causes their regional disparities. On the other hand, the Advisory Committee on Immunization Practices (ACIP) in the United States recognizes importance of economic analyses in establishing policy for addition of new vaccines to routine immunization schedules. The ACIP publishes guidance for health economic studies to ensure that high quality economic data are presented in a standard format. In this study, a critical review of economic analyses for childhood vaccine programs in Japan was conducted. Six original studies that included varicella, mumps, Hib (haemophilus influenza type B), pneumococcal disease and human papillomavirus vaccines were identified by a systematic literature review. The results of all studies suggested that these new vaccines should be included to routine immunization schedules because expected benefits would outweigh additional costs of vaccines. However, according to the check lists recommended by ACIP guideline, these studies utilized various sources of cost information and calculated opportunity costs differently. Some studies did not consider discounting of future costs. Therefore, direct comparisons between studies were very difficult. Economic analyses to evaluate the priority of vaccine programs should follow a standard method to increase comparability and quality of studies.