Program Cost Analysis
Program cost analysis is an approach to estimate the costs of implementing a program or intervention. For example, in one analysis, school–based dental sealant programs have been estimated to cost on average $76 per child receiving sealants.1
Economic analyses use economic costs rather than ﬁnancial costs alone to determine the value of resources used. For example, the ﬁnancial cost of volunteer time may be zero. But if a program relies on volunteers, their time must be valued to more completely capture the economic costs of the program.
Financial costs are actual monetary expenditures for resources, such as staff salaries, facility rent, and medical supplies.
Economic costs include ﬁnancial costs plus the value of resources that are not paid for (but must be monetized), such as volunteer time, caregiver time, and donated space and equipment.
What inputs are included?
A program cost analysis includes the monetary value of all resources (people, places, things) used for the program or intervention. These include:
- Direct costs are costs of resources used to design and implement an intervention, such as personnel time, facility rent, supplies, and medications. These may be split into medical and non-medical costs.
- Productivity losses are impacts of patient or caregiver participation in an intervention, such as work time lost or leisure time lost due to participation in the intervention. These costs are generally more complicated to measure than direct costs.
- Intangible costs are non-ﬁnancial costs, such as pain and suffering, which impose a major burden on individuals. These are the hardest costs to measure and are included less frequently than direct and productivity costs.
What output does a program cost analysis provide?
Program cost analysis provides the total cost of a program or intervention.
Program Cost Analysis Example2:
The following example shows a program cost analysis of a routine childhood vaccination program for children born in 2009.
Routine Childhood Vaccinations
Vaccine costs, cost of clinic
visit to administer vaccine
Cost of Caregiver
time off work
As you can see, the inputs include direct costs and productivity losses, but not intangible costs. The output from the analysis is a $7.5 billion estimated total program cost of vaccinating 4.3 million children born in 2009.
For additional information, please see the example as used in the CDC Introduction to Economic Evaluation in Public Healthexternal icon online training, as well as the original studyexternal icon.
How can decision makers use this information?
Because resources are limited, program cost analysis can be useful in understanding the costs of implementing different programs under consideration. It also provides information useful for budgeting and performance monitoring.
- Grifﬁn, S.O., Naavaal, S., Scherrer, C., Patel, M., Chattopadhyay, S. and Community Preventive Services Task Force, 2017. Evaluation of school-based dental sealant programs: an updated community guide systematic economic review. American Journal of Preventive Medicine, 52(3), pp.407-415.
- Zhou F, Shefer A, Wenger J, Messonnier M, Wang LY, Lopez A, et al. Economic evaluation of the routine childhood immunization program in the United States, 2009. Pediatrics. 2014;133(4):577-585. http://www.ncbi.nlm.nih.gov/pubmed/24590750external icon