Table 2 Definitions of costing terms by guidance document
From: WHO-led consensus statement on vaccine delivery costing: process, methods, and findings
EPIC (including ‘How to Cost Immunization Programs’ and the Common Approach) | GHCC | ICAN | WHO 2002 Guidelines for Introducing New Vaccines | Costing Tools’ User Manuals (CHOLTOOL, C4P, SIICT)a | WHO cMYP Guideline | |
|---|---|---|---|---|---|---|
Vaccine delivery cost | All resources used, whether immunization-specific, or ‘shared, and whether consumed at immunization delivery “sites” or above the level of service delivery, with and without the new vaccine (How to cost immunization programs, pg. 4) [12] | NA | Costs associated with delivering immunizations to target populations, exclusive of vaccine costs (pg.11) [6] | NA | Vaccine delivery includes startup costs, service delivery (personnel time, supplies and transport/allowance), vaccine procurement, monitoring and supervision, and other costs (C4P guide, pg. 262) [15] (Not included in other tool manuals) | NA |
Financial cost | A financial costing is concerned with accounting transactions (i.e., monetary outlays or expenditures) (How to cost immunization programs, pg. 7) [12] | Capture the resources that are “paid” for (pg. A-8) [8] | Financial outlays, usually with straight-line depreciation of capital items (pg. 31) [6] | Actual expenditure for resources used for goods or services purchased. Does not include cost of existing health personnel time or donated goods (pg. 2) [14] | Actual monetary flows of the buyer such as the Ministry of Health. Does not include the value of resources already paid for, such as personnel time (SIICT guide, pg. 21) [17] | NA |
Economic cost | An economic costing values resources based on their opportunity cost, regardless of whether a financial transaction occurred (How to cost immunization programs, pg. 7) [12] | The value of the highest alternative health intervention opportunity forgone; captures the full value forgone of all resources used (pg. A-8) [8] | Financial outlays plus opportunity costs such as health worker time and any donated items such as vaccines (pg. 56) [6] | Resources that have been foregone for alternative uses, or opportunity costs (pg. 2) [14] | Estimates all costs of an intervention, regardless of the source of funding, so that the opportunity cost of all resources is accounted for in the analysis, includes in-kind and donor contributions (SIICT guide, pg. 21) [17] | NA |
Undepreciated financial costs (sometimes called initial investment in costing tool guides and referred to as fiscal costs in previous analyses) | Reflect what governments and donors have paid for activities, services, and goods (Common Approach, pg. 19) [11] | NA | Financial outlays, usually without depreciation of capital items (pg. 31) [6] | NA | Initial upfront resource requirements (C4P guide, pg. 268) [15] | NA |
Recurrent cost | Recurrent items include labor and consumable items such as vaccines doses, supplies and travel costs (How to cost immunization, pg. 11) [12] | Value of resources/inputs with useful lives of less than one year (pg. 61) [8] | NA | Items that are used up during a year (pg. 3) [14] | Goods or items used in the delivery of a service or intervention that last less than a year, e.g., personnel salaries (SIICT guide, pg. 21) [17] (Not included in all tool manuals) | Costs of resources consumed within one year (CMYP guide, pg. 19) [16] |
Capital cost (sometimes called investment cost) | Capital items are durable items such as building, equipment, and vehicles (How to cost immunization, pg. 11) [12] | One-time costs for items that have a useful life of over one year (pg. B-23) [8] | NA | Items that last longer than one year and are therefore incurred only every few years rather than annually (pg. 3) [14] | Goods that last for longer than one year, such as equipment (SIICT guide, pg. 21) [17] | An input that has a useful life of more than one year (cMYP guide, pg. 19) [16] |
Incremental cost | Make assumptions about what particular resources were affected by the intervention, and only measure those resources (How to cost immunization, pg. 8) [12] | Cost of adding a new or a batch of services or intervention over and above an existing program (pg. 59) [8] | Additional costs associated with introducing new vaccines or making changes in delivery (pg. 32) [6] | Only looks at the cost of an addition, e.g., a new vaccine, to existing services (pg. 2) [14] | Additional resources required to add an intervention to an existing immunization program (CHOLTOOL guide, pg. 6) [13] (Not included in other tool manuals) | NA |
Full cost | Full costs include baseline cost as well as the additional cost of the new intervention (How to cost immunization, pg. 8) [12] | NA | The sum of all costs associated with vaccination delivery (pg. 31) [6] | NA | NA | NA |
Cost projections | NA | NA | NA | NA | NA | Total future costs of both recurrent and capital inputs to the NIP (cMYP guide, pg. 108) [16] |
Prospective data collection | Direct observation (How to Cost Immunization Programs, pg. 21) [12] | Direct observation of resource use (pg. B-18) [8] | NA | NA | NA | NA |
Retrospective data collection | NA | Data collection takes place after resource use (pg. B-18) [8] | NA | NA | NA | NA |
Start-up or introduction costs | Costs that are incremental to the routine immunization system and specifically incurred as a result of introduction of the new vaccine (Common Approach, pg.6) [11] All resources used for one-time activities (e.g., social mobilization, cold chain capacity mobilization expansion) in a defined time period around the introduction (How to Cost Immunization, pg. 4) [12] | NA | NA | NA | Initial one-time programmatic activities and include micro-planning, initial training activities, and initial sensitization/social mobilization/IEC (SIICT guide, pg.21) [17] (Not included in other tool manuals) | NA |