A review of the sustainability of vaccine funding across Europe and implications for post-COVID policymaking. Issue 10 (October 2022)

• Record Type: Journal Article
• Authors: Lawlor, Ryan; Wilsdon, Tim; Rémy-Blanc, Vanessa; Nogal, Agustín Álvarez; Pana, Adrian
• Is Part Of: Health policy. Volume 126:Issue 10(2022)
• Page Start: 956
• Page End: 969
• Publication Date: 2022-10
• Subjects: Routine vaccination -- Vaccine budgets -- Vaccine funding -- Patient access -- Europe; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2022.08.004
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Vaccine funding pathways and the associated budget-setting processes vary greatly across Europe. Some countries have flexible healthcare budgets supporting vaccines, creating no spending limits. Public health budgets may be restricted by upstream budgetary limits. Identification of key characteristics created a systematic way to compare funding approaches. Recommendations to improve sustainability include accountability, cooperation, flexibility, transparency, allocation and equity. Abstract: Background: Approaches to routine vaccine funding and the underlying budget-setting process vary greatly across European countries. The ongoing COVID-19 pandemic has put enormous pressure on healthcare systems, affecting resilience of the overall vaccine ecosystem. Methods: This article reviews how vaccine budgets are structured across 8 European countries (England, Finland, France, Germany, Italy, Norway, Romania, and Spain). First a literature review of the landscape was undertaken, followed by expert interviews to review the findings and consider policy principles to secure prioritisation and sustainability of routine vaccination budgets post-COVID. Results: The organisation of budgets and vaccine spending varies greatly across Europe. In 2/8 countries (France and Germany) vaccine spending is subsumed into a wider healthcare budget. In 2/8 countries (Italy and Romania) the budget differentiates public health and prevention spending from other areas of healthcare, though there is no standalone vaccine budget. In 4/8 countries (England, Finland, Norway and Spain) there is a standalone vaccine budget, however this may not cover all elements needed for immunisation delivery and is not always transparent. Conclusion: Ensuring adequate and dynamic country vaccine budgets, with horizon scanning approaches like in England and Finland, or flexible vaccines expenditures like Germany, would greatly help the timely availability of public funding for new vaccines and strengthen vaccines supply security in Europe through a more virtuous European vaccine ecosystem.