A second affordable oral cholera vaccine: implications for the global vaccine stockpile

Desai, Sachin N.; Pezzoli, Lorenzo; Martin, Stephen J.; Costa, Alejandro; Rodrı́guez, Carmen; Legros, Dominique; Perea, William

doi:10.1016/s2214-109x(16)00037-1

Cited by 47 publications

(45 citation statements)

References 6 publications

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“…All three vaccines require two doses for full protection [25]. While Dukoral ® is mainly used for travellers, providing approximately 65% protection against cholera for 2 years, Shanchol ® and Euvichol ® do not require a buffer solution for administration, which makes them easier to administer to large numbers of people in emergency contexts [3].…”

Section: Discussionmentioning

confidence: 99%

Cholera — the new strike of an old foe

Kuna

Gajewski

2017

International Maritime Health

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Section: Discussionmentioning

confidence: 99%

Cholera — the new strike of an old foe

Kuna

Gajewski

2017

International Maritime Health

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“…Even if a country receives donated OCVs, international transportation of the donated vaccines to its borders as well as the clearance of the vaccines at the point of entry accounts for a sizable proportion of the costs. Besides scaling up vaccine supply through the entry of multiple competitive manufacturers [34], a single dose vaccine strategy, if deployed, particularly in outbreak settings is likely to lower vaccine costs [35]. The vaccine administration cost was the next highest because it involves intensive efforts to reach each individual to be vaccinated that needs lot of human resources, cold chain and materials such as vaccination card, soap, water and cups.…”

Section: Discussionmentioning

confidence: 99%

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review

et al. 2016

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BackgroundUse of the oral cholera vaccine (OCV) is a vital short-term strategy to control cholera in endemic areas with poor water and sanitation infrastructure. Identifying, estimating, and categorizing the delivery costs of OCV campaigns are useful in analyzing cost-effectiveness, understanding vaccine affordability, and in planning and decision making by program managers and policy makers.ObjectivesTo review and re-estimate oral cholera vaccination program costs and propose a new standardized categorization that can help in collation, analysis, and comparison of delivery costs across countries.Data sourcesPeer reviewed publications listed in PubMed database, Google Scholar and World Health Organization (WHO) websites and unpublished data from organizations involved in oral cholera vaccination.Study eligibility criteriaThe publications and reports containing oral cholera vaccination delivery costs, conducted in low- and middle-income countries based on World Bank Classification. Limits are humans and publication date before December 31st, 2014.ParticipantsNo participants are involved, only costs are collected.InterventionOral cholera vaccination and cost estimation.Study appraisal and synthesis methodA systematic review was conducted using pre-defined inclusion and exclusion criteria. Cost items were categorized into four main cost groups: vaccination program preparation, vaccine administration, adverse events following immunization and vaccine procurement; the first three groups constituting the vaccine delivery costs. The costs were re-estimated in 2014 US dollars (US$) and in international dollar (I$).ResultsTen studies were identified and included in the analysis. The vaccine delivery costs ranged from US$0.36 to US$ 6.32 (in US$2014) which was equivalent to I$ 0.99 to I$ 16.81 (in I$2014). The vaccine procurement costs ranged from US$ 0.29 to US$ 29.70 (in US$2014), which was equivalent to I$ 0.72 to I$ 78.96 (in I$2014). The delivery costs in routine immunization systems were lowest from US$ 0.36 (in US$2014) equivalent to I$ 0.99 (in I$2014).LimitationsThe reported cost categories are not standardized at collection point and may lead to misclassification. Costs for some OCV campaigns are not available and analysis does not include direct and indirect costs to vaccine recipients.Conclusions and implications of key findingsVaccine delivery cost estimation is needed for budgeting and economic analysis of vaccination programs. The cost categorization methodology presented in this study is helpful in collecting OCV delivery costs in a standardized manner, comparing delivery costs, planning vaccination campaigns and informing decision-making.

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“…And where there are few instances that have established empirical evidence of equivalent outcomes for affordable healthcare interventions, the relevance of frugal models or technologies are usually espoused as relevant to mainly low-resource settings. See, for instance, two recent articles in the Lancet , one for affordable vaccines,30 and the other for the affordable assessment of haemoglobin,31 as well as one article in New England Journal of Medicine on mosquito mesh for hernia surgery 32. The NEJM paper concludes: ‘In summary, this study showed that a low-cost mesh can be used in hernia repair with excellent clinical outcomes that do not differ significantly from those achieved with commercial mesh.…”

Section: Discussionmentioning

confidence: 85%

The search for the holy grail: frugal innovation in healthcare from low-income or middle-income countries for reverse innovation to developed countries

et al. 2017

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The healthcare sector stands to benefit most from frugal innovation, the idea that more can be done for less for many more people, globally. As a first step for health systems to leverage new approaches to offset escalating health expenditures and to improve health outcomes, the most relevant frugal innovations have to be found. The Institute of Global Health Innovation was commissioned by the US-based Commonwealth Fund to identify frugal innovations from around the world that could, if transferred to the USA, offer approaches for expanding access to care and dramatically lower costs. Our global scan was motivated by the need to extend the list of frugal innovations in healthcare beyond the impressive but oft-repeated examples such as GE’s MAC 400, a US$800 portable ECG machine, Narayana’s US$1500 cardiac surgery and Aravind’s US$30 cataract surgery. Our search involved (1) scanning innovation databases, (2) refining frameworks to identify frugal innovations and evaluate their reverse potential and (3) developing in-depth case studies. From 520 possible innovations, we shortlisted 16 frugal innovations that we considered as frugal and with potential for reverse diffusion into high-income country health systems. Our global search was narrowed down to three care delivery models for case analysis: The Brazilian Family Health Strategy around community health workers; Singapore-based GeriCare@North use of telemedicine and Brazil’s Saude Crianca community involvement and citizenship programme. We share core features of the three frugal innovations and outline lessons for practitioners, scholars and policymakers seeking to lower healthcare costs while increasing access and quality.

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A second affordable oral cholera vaccine: implications for the global vaccine stockpile

Cited by 47 publications

References 6 publications

Cholera — the new strike of an old foe

Cholera — the new strike of an old foe

Oral Cholera Vaccination Delivery Cost in Low- and Middle-Income Countries: An Analysis Based on Systematic Review

The search for the holy grail: frugal innovation in healthcare from low-income or middle-income countries for reverse innovation to developed countries

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