The Immunization Costing Action Network (ICAN) was a research and learning network for increasing the visibility, availability, understanding and use of immunization delivery cost information. The ICAN worked with countries to build capacity around the generation of costing evidence and to improve the interpretation and translation of this data so that it is used in country decision-making processes and informs planning and budgeting. ICAN was supported by the Bill & Melinda Gates Foundation.
As more low- and middle-income countries transition to self-financed immunization programs, governments need accurate and reliable cost information to ensure they mobilize adequate resources to meet coverage goals, address challenges of health equity, effectively manage the introduction of new vaccines and the implementation of campaigns, and achieve efficiencies; however, cost data is often of variable quality, hard to compare, and is difficult to access and use by policymakers, program planners, and other global and country-level stakeholders. The goal of ICAN was to help planners and decision-makers generate, access, understand, and use evidence on the cost of delivering vaccines.
Global research and analytics
ThinkWell completed a systematic review of over 17,000 articles and reports presenting immunization delivery cost data for a variety of vaccines, delivery strategies, types of cost analysis, and low-and middle-income country settings. The purpose of the review was to answer the question “What are the unit costs of vaccine delivery across different low-and middle-income countries and through a variety of delivery strategies?” To make the data accessible and easy to understand, ThinkWell developed the Immunization Delivery Cost Catalogue (IDCC) and methodology note, analytic report, and how-to user guides. ThinkWell also published the methods and findings in Vaccine: X.
Country research and evidence to policy
The ICAN was comprised of three-member countries—Indonesia, Tanzania, and Vietnam—with country teams that include health economist researchers and immunization managers and planners from Ministries of Health. The country teams have conducted costing studies that explored the cost of delivering vaccines through different delivery strategies to diverse geographies and to distinct target populations. ThinkWell and John Snow, Inc. (JSI) facilitated knowledge sharing around effective strategies for generation of cost evidence and its use in decision-making processes and in routine policy and planning. The full study reports for Indonesia, Tanzania and Vietnam can be accessed here.
Standardizing campaign costing
Immunization campaigns are increasingly used to improve coverage and decrease morbidity and mortality from vaccine-preventable diseases. Underfunded campaigns can result in a low impact and thus are an inefficient use of resources. Accurate financial planning is required to ensure that campaigns achieve coverage targets, but evidence of what it costs to conduct campaigns is limited, somewhat outdated, and varies greatly. The extent to which cost variation is driven by differences in costing study methodologies or campaign operations is not clear. To address this issue, the ICAN developed methodological guidance to standardize campaign costing which was informed by learnings from three campaign costing studies.
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