Financing Strategies of Influenza Vaccination in China

Questions were designed in the questionnaire to ask the economic burden of influenza-like illness (ILI), including direct and indirect costs. Specifically, direct costs include inpatient cost (both out-of-pocket and reimbursed, range 0-100,000), hospitalization cost (both out-of-pocket and reimbursed, range 0-500,000), drug cost (both out-of-pocket and reimbursed, range 0-100,000), transportation cost (range 0-100,000), accommodation cost range (0-100,000) and food cost (range 0-100,000). Indirect cost include missed working days of the patients and their relatives/friends.

Questions were designed in the questionnaire to ask interviewees' willingness to pay for influenza vaccination. A value between 0 and 150 RMB will be randomly generated, and ask the respondent whether he or she is willing to pay for influenza vaccination. For example, one is asked "Would you like pay 102 for influenza vaccination?" If the answer is "Yes", then he or she will be asked "Would you like pay 112 for influenza vaccination?" If the answer is "No", then he or she will be asked "Would you like pay 92 for influenza vaccination?" The willingness to pay is then settled and recorded. Moreover, the proportion of vaccination cost paid by individuals will be asked (if others will be paid by health insurance and the government).

Immunization records of children were collected. Questions were designed in the questionnaire to evaluate the degree of vaccine hesitancy of interviewees. Respondents will be asked abound their confidence, convenience and complacency about vaccination of different vaccines (include influenza, Hib, PCV, Rota and chickenpox), so as to further explore the influencing factors of people's vaccination behaviors.

Financing strategies will be further discussed according to literature review, government reports, and the results of willingness to pay.

Literature review will be done to learn about the financing strategies of influenza vaccination all over the world. Government reports on basic public health financing will be an important evidence and reference. The results of willingness to pay from the questionnaire estimate the amount (0-150) and proportion (0-100%) an individual is willing to pay for influenza vaccination.

Combining the three information sources, a supply-demand curve can be drawn to decide the optimal financing strategies of influenza vaccine, and the cross-region inequities in China will also be taken into consideration.

An extra questionnaire was specially designed for a small portion of randomly chosen interviewees to conduce discrete choice experiment. In the discrete choice experiment, different packages of vaccine will be given for respondents to choose from. These packages have different characteristics in terms of protection duration, vaccine cost, efficacy, safety and production place. In the experiment, participants are asked to choose one package from 10 pairs of packages (package A and package B) according to their own preferences. Their preferences (protection duration, vaccine cost, efficacy, safety and production place) will be calculated and ranked according to the experiment results.