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Novel method estimates cholera vaccination costs in low-, middle-income countries
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Researchers have developed a new standardized methodology to analyze the full costs for oral cholera vaccination implementation in low- and middle-income countries that may aid in comparing delivery costs and planning vaccination campaigns, per a recent study.
“When deploying a new vaccine, besides routine recurrent costs, the introduction cost such as initial planning, extra logistics and cold chain, training, social mobilization, sensitization, and other new implementation activities such as management of Adverse Events Following Immunization should be considered,” Vittal Mogasale, MBBS, MPH, PhD, a research scientist and head of the policy and economic research department in the development and delivery unit at the International Vaccine Institute, Seoul, Korea, and colleagues wrote. “Analysis of cost items help to identify major cost drivers in mass vaccination programs which are critical elements in planning program implementation.”
To describe the different costs of separate activities required for oral cholera vaccine delivery in low- and middle-income countries (n = 8) with a gross national income per capita of $4,035 or less, Mogasale and colleagues reviewed 10 previously published papers pertaining to oral cholera vaccination from online databases. The researchers then analyzed costs described in the papers and organized them into four groups: vaccination program preparation, vaccine administration, adverse events following immunization management and vaccine procurement. In addition, the researchers applied three methods of program cost estimates to adjust for different costs of living and same base year to draw comparisons between countries, and converted the sum of all categories to both 2014 U.S. dollars and 2014 international (I$) dollars.
Analysis showed that vaccine delivery costs differed by country, as well as in the same country and with the same settings. The cost of ShanChol oral cholera vaccine (Shantha Biotec; India) in ranged from U.S. $1.14 in India to U.S. $3.05 in South Sudan per immunized person. Additionally, the delivery costs — the sum of preparation, vaccine administration and adverse events — varied from U.S. $0.36 to U.S. $6.32 per vaccination, which was equivalent to I$0.99 to I$16.81; and the procurement costs ranged from U.S. $0.29 to U.S. $29.70, equivalent to I$0.72 to I$78.96.
“Understanding the costs of cholera vaccination campaigns is of paramount importance in the economic evaluation as well as in planning future vaccination programs,” the researchers said in a press release. “The categories described … allow for a clear, comparative understanding of vaccination campaign costs that can better describe decision-making.” – by Kate Sherrer
Disclosure: This study was funded by the Bill and Melinda Gates Foundation through the Johns Hopkins University Bloomberg School of Public Health grant CHJOH05064-010. The authors report no relevant financial disclosures.
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