Estimating the cost of cholera-vaccine delivery from the societal point of view: A case of introduction of cholera vaccine in Bangladesh

Sarker, Abdur Razzaque; Islam, Ziaul; Khan, Iqbal Ansary; Saha, Amit; Chowdhury, Fahima; Khan, Ashraful Islam; Cravioto, Alejandro; Clemens, John D.; Qadri, Firdausi; Khan, Jahangir

doi:10.1016/j.vaccine.2015.07.042

Cited by 25 publications

(25 citation statements)

References 19 publications

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“…Adding these vaccine recipient costs would be valuable for a better understanding of the total costs of vaccination and help in developing plans to reduce vaccine recipient’s costs which may improve vaccine acceptance [38]. Two of the Shanchol costing studies later published OCV delivery costs under societal perspective [37,39]. Second, several of the studies included in our analysis organized the costs using their own methods and costing categories, which made it difficult to reorganize the costs for the purposes of our analysis [12–14,20].…”

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reviewed publications listed in PubMed database, Google Scholar and World Health Organization (WHO) websites and unpublished data from organizations involved in oral cholera vaccination.Study eligibility criteriaThe publications and reports containing oral cholera vaccination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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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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“…The projected operational costs of delivering the vaccine were taken from a study of oral cholera vaccination costs conducted during the OCV feasibility study in Mirpur, Dhaka [ 21 ]. These costs included: 1) start-up costs: training materials, social mobilization, and training; and 2) service delivery costs: personnel salaries, supplies, vaccine transport, cold chain storage and equipment and waste management.…”

Section: Methodsmentioning

confidence: 99%

The impact and cost-effectiveness of controlling cholera through the use of oral cholera vaccines in urban Bangladesh: A disease modeling and economic analysis

et al. 2018

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BackgroundCholera remains an important public health problem in major cities in Bangladesh, especially in slum areas. In response to growing interest among local policymakers to control this disease, this study estimated the impact and cost-effectiveness of preventive cholera vaccination over a ten-year period in a high-risk slum population in Dhaka to inform decisions about the use of oral cholera vaccines as a key tool in reducing cholera risk in such populations.Methodology/Principal findingsAssuming use of a two-dose killed whole-cell oral cholera vaccine to be produced locally, the number of cholera cases and deaths averted was estimated for three target group options (1–4 year olds, 1–14 year olds, and all persons 1+), using cholera incidence data from Dhaka, estimates of vaccination coverage rates from the literature, and a dynamic model of cholera transmission based on data from Matlab, which incorporates herd effects. Local estimates of vaccination costs minus savings in treatment costs, were used to obtain incremental cost-effectiveness ratios for one- and ten-dose vial sizes. Vaccinating 1–14 year olds every three years, combined with annual routine vaccination of children, would be the most cost-effective strategy, reducing incidence in this population by 45% (assuming 10% annual migration), and costing was $823 (2015 USD) for single dose vials and $591 (2015 USD) for ten-dose vials per disability-adjusted life year (DALY) averted. Vaccinating all ages one year and above would reduce incidence by >90%, but would be 50% less cost-effective ($894–1,234/DALY averted). Limiting vaccination to 1–4 year olds would be the least cost-effective strategy (preventing only 7% of cases and costing $1,276-$1,731/DALY averted), due to the limited herd effects of vaccinating this small population and the lower vaccine efficacy in this age group.Conclusions/SignificanceProviding cholera vaccine to slum populations in Dhaka through periodic vaccination campaigns would significantly reduce cholera incidence and inequities, and be especially cost-effective if all 1–14 year olds are targeted.

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“…This framework aims to identify households in Bangladesh that are at risk of contracting cholera. According to Sarker et al, 2015, "In Bangladesh, there is no well-documented data on the actual number of cholera cases but expert estimates suggest an incidence of approximately 450,000-1,000,000 cases each year, of which, at least 300,000 are severe cholera cases. "…”

Section: Appendix A: Metadata For Cholera Framework and Componentsmentioning

confidence: 99%

“…Jutla et al 2013, calls for a cholera prediction model to include vaccination of vulnerable demographic groups in advance. Sarker et al 2015, states that the WHO "recommends using oral cholera vaccines as a public health tool in addition to traditional prevention practices and treatments in both epidemic and endemic settings." Unfortunately, in developing countries such as Bangladesh, affordability of the vaccine prevents the expansion of cholera vaccine programs.…”

Section: Uncertainty Valuesmentioning

confidence: 99%

Development of a cholera epidemiological risk assessment framework

Bastian¹,

Munaretto²,

Myers³

et al. 2019

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Estimating the cost of cholera-vaccine delivery from the societal point of view: A case of introduction of cholera vaccine in Bangladesh

Cited by 25 publications

References 19 publications

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

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

The impact and cost-effectiveness of controlling cholera through the use of oral cholera vaccines in urban Bangladesh: A disease modeling and economic analysis

Development of a cholera epidemiological risk assessment framework

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