Hou Zhiyuan, Yue Dahai, Fang Hai, Meng Qingyue, Zhang Yuting
China Center for Health Development Studies, Peking University, Mailbox 505, 38 Xue Yuan Road, Haidian District, Beijing 100191, China.
Center for Health Management and Policy, Shandong University, 44 Wenhua Xi Road, Jinan 250012, China.
Vaccine. 2014 Jul 31;32(35):4471-4477. doi: 10.1016/j.vaccine.2014.06.047. Epub 2014 Jun 23.
While vaccines not covered by China's Expanded Program on Immunization can be received voluntarily with out-of-pocket payment, the uptake of self-paid vaccines in China is low.
To investigate willingness to pay (WTP) for self-paid vaccines and its determinants in China.
We interviewed 2160 randomly selected households with children 0-3 years old, in 108 communities from three provinces in 2013. A bidding game method was used to elicit WTP for two self-paid vaccines: 7-valent pneumococcal conjugate vaccine and influenza vaccine. We conducted multivariate linear regressions to determine factors affecting the WTP.
Median WTP for pneumococcal conjugate vaccine and influenza vaccine were Chinese Yuan 200 and 60 (10 US Dollars). 92% and 55% of respondents, respectively were not willing to pay the market price for these two vaccines. Lower price barrier and higher ability to pay were associated with higher WTP. Those with better vaccine or disease-related knowledge, higher perceived vulnerability and severity of diseases were willing to pay more. However, perceived effectiveness and safety barriers to vaccination had no significant effects on the WTP. Recommendations from peers and healthcare providers increased the WTP. Fathers and grand parents of children had a higher WTP than their mothers. The WTP decreased with age, but was not affected by education and occupation.
The majority of individuals, in our study, were not willing to pay the market price for self-paid vaccines against high-burden diseases in China. The economic barriers to vaccination should therefore be removed to increase the demand. Region-specific information about disease burden, fiscal capacity and cost-effectiveness is important for the development of local financing policy in order to cover vaccination costs. Interventions targeting psychosocial factors, such as health education and communication with providers and peers, could also be effective in increasing the uptake of these vaccinations.
虽然中国扩大免疫规划未涵盖的疫苗可以自费自愿接种，但中国自费疫苗的接种率较低。
调查中国自费疫苗的支付意愿（WTP）及其决定因素。
2013年，我们在来自三个省份的108个社区中随机抽取了2160户有0至3岁儿童的家庭进行访谈。采用投标博弈法来确定两种自费疫苗（7价肺炎球菌结合疫苗和流感疫苗）的支付意愿。我们进行了多元线性回归以确定影响支付意愿的因素。
肺炎球菌结合疫苗和流感疫苗的支付意愿中位数分别为200元和60元（10美元）。分别有92%和55%的受访者不愿意支付这两种疫苗的市场价格。较低的价格门槛和较高的支付能力与较高的支付意愿相关。那些对疫苗或疾病相关知识了解较好、感知到的脆弱性和疾病严重程度较高的人愿意支付更多。然而，对疫苗接种的有效性和安全性的认知障碍对支付意愿没有显著影响。来自同伴和医疗服务提供者的建议增加了支付意愿。孩子的父亲和祖父母的支付意愿高于母亲。支付意愿随年龄增长而降低，但不受教育程度和职业的影响。
在我们的研究中，大多数人不愿意为中国针对高负担疾病的自费疫苗支付市场价格。因此，应消除疫苗接种的经济障碍以增加需求。关于疾病负担、财政能力和成本效益的特定地区信息对于制定地方融资政策以支付疫苗接种费用很重要。针对心理社会因素的干预措施，如健康教育以及与提供者和同伴的沟通，也可能有效地提高这些疫苗的接种率。
