IMFIN brief 22: Costa Rica, lottery contributions for immunization in a mixed financing system

Lotteries are among the innovative mechanisms that countries may consider for immunization financing. What role has the national lottery played in financing vaccines in Costa Rica?

Key points

• Costa Rica’s immunization program is financed primarily by the national health insurance program, known as the Caja, which provides health services to about 90% of the population.
• Financing for vaccines comes from three sources: the Caja, the Ministry of Health, and the national lottery. The Caja covers all immunization delivery costs.
• The national lottery is an innovative financing source but accounts for only about 1% of the annual cost of vaccines.
• New vaccine introduction is a challenge in Costa Rica due to financial pressures faced by both the Caja and the Ministry of Health. An added challenge is lack of clarity on the two institutions’ respective roles in financing vaccines.