Community Pharmacist, Lherm, France.
IQVIA, Paris, France.
BMC Health Serv Res. 2024 Jul 25;24(1):845. doi: 10.1186/s12913-024-11093-x.
The vaccine coverage rate (VCR) for human papillomavirus (HPV) in France is one of the lowest in Europe, well below the target of 80% announced in the French Cancer Plan 2021-2030. The extension of vaccination competencies (prescription and administration) to new health care providers, such as community pharmacists (CPs), was a decisive step by the French Health Authority (HAS) in 2022 to simplify access to vaccination and improve the VCR. This research assessed the economic and organizational impacts (OIs) of the extension of vaccination competencies in France.
A model was developed in Excel® to compare the current HPV vaccination pathway focused on general practitioners (GPs) to a mix of pathways (new and current) that extends pharmacists' competencies (prescription and/or injection). The simulated population corresponded to girls and boys targeted by the French recommendations. The model was run from 2023 to 2030. HAS guidelines were used to identify OIs related to these new pathways. Model inputs were collected from national data sources and an acceptability study. The results focused on three OIs (HPV vaccination ability [defined as the number of adolescents who could be vaccinated in each pathway], the VCR projection, and flows of activity between health care professionals]). The economic impact was evaluated from the National Health Insurance (NHI) perspective in 2022.
With a mix of vaccination pathways, including an increasing role of pharmacists, the target of an 80% VCR could be reached in 2030 (versus 2032 with the current pathway) with lower investment than the current situation, resulting in cost savings for the NHI of €212 million. Expanding vaccination competencies will provide pharmacists with additional revenue (an average of €755,000/month for all vaccinating pharmacies) and will free up medical time for GPs (average of 603,000 consultations/year for all GPs).
Expanding vaccination competencies to pharmacists has a positive impact on the entire ecosystem. From a public health perspective, the national VCR target can be achieved and better access to care can be provided, freeing up medical time. From an economic perspective, this approach can provide savings for the NHI and additional revenue for pharmacists.
法国的人乳头瘤病毒（HPV）疫苗接种率（VCR）是欧洲最低的国家之一，远低于 2021-2030 年法国癌症计划宣布的 80%目标。法国卫生署（HAS）在 2022 年将疫苗接种权限（处方和管理）扩展到新的医疗保健提供者，如社区药剂师（CPs），这是一个决定性的步骤，旨在简化疫苗接种的获取途径并提高 VCR。本研究评估了法国扩大疫苗接种权限的经济和组织影响（OIs）。
使用 Excel®开发了一个模型，将目前专注于全科医生（GPs）的 HPV 疫苗接种途径与混合途径（新途径和现有途径）进行比较，后者扩大了药剂师的权限（处方和/或注射）。模拟人群对应于法国建议的目标女孩和男孩。该模型从 2023 年到 2030 年运行。使用 HAS 指南来确定与这些新途径相关的 OIs。模型输入是从国家数据来源和可接受性研究中收集的。结果集中在三个 OIs（HPV 疫苗接种能力[定义为每个途径可接种的青少年人数]、VCR 预测以及卫生保健专业人员之间的活动流量]）。从 2022 年国家健康保险（NHI）的角度评估了经济影响。
通过混合疫苗接种途径，包括增加药剂师的作用，可以在 2030 年达到 80%的 VCR 目标（与当前途径相比为 2032 年），投资低于现状，为 NHI 节省 2.12 亿欧元。扩大疫苗接种权限将为药剂师提供额外收入（所有接种疫苗的药房平均每月 75.5 万欧元），并为全科医生腾出医疗时间（所有全科医生每年平均 60.3 万次就诊）。
向药剂师扩大疫苗接种权限对整个生态系统具有积极影响。从公共卫生的角度来看，可以实现国家 VCR 目标，并提供更好的医疗服务，同时腾出医疗时间。从经济角度来看，这种方法可以为 NHI 节省资金，并为药剂师提供额外收入。
