Economics and financing of vaccines for diarrheal diseases

Bartsch, Sarah M.; Lee, Bruce Y.

doi:10.4161/hv.28885

Cited by 8 publications

(4 citation statements)

References 94 publications

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“…Along with the health burden, diarrheal infections have potential economic impact on diarrhoea affected households. A number of studies focused on the economic burden of diarrheal infections in various countries [20,21,22,23,24,25], but the knowledge about caregivers costs of a full diarrheal episode are still limited in resource-poor settings, particularly in the context of Bangladesh. Various hospital-based costing studies were conducted in Bangladesh to estimate treatment cost per patients from the provider’s perspective [26,27].…”

Section: Discussionmentioning

confidence: 99%

“…There are numerous studies focusing on the economics of diarrheal disease around the world however, research focusing on the caregivers’ cost during the diarrheal episode is still limited globally [20,21,22,23,24,25]. A hospital-based study captured the unit cost of inpatients and outpatients from providers’ points of view rather than household perspectives in Asia [26].…”

Section: Introductionmentioning

confidence: 99%

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Cost of Caregivers for Treating Hospitalized Diarrheal Patients in Bangladesh

et al. 2018

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Introduction: Diarrheal diseases are a global public health problem and one of the leading causes of mortality, morbidity and economic loss. The objective of the study is to estimate the economic cost of caregivers and cost distribution per diarrheal episodes in Bangladesh. Methods: This was a cross-sectional hospital-based study conducted in public hospitals in Bangladesh. A total of 801 diarrheal patients were randomly selected and interviewed during January to December 2015. Simple descriptive statistics including frequencies, percentage, mean with 95% CI and median are presented. Results: The overall average cost of caregivers was BDT 2243 (US$ 28.58) while only BDT 259 (US$ 3.29) was spent as out of pocket payments. Caregivers mostly spent money (US$ 1.63) for food, lodging, utility bills, and other lump sum costs followed by the transportation costs (US$ 1.57). The caregivers spent more (US$ 44.45) when they accompanied the patients who were admitted in inpatients care and almost 3.6 times higher than for out-patients care (US$ 12.42). Conclusions: The study delivers an empirical evidence to the health-care programmers and policy makers about the economic cost of caregivers during diarrheal treatment care, which should be accounted for in designing future diarrheal prevention programme.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cost of Caregivers for Treating Hospitalized Diarrheal Patients in Bangladesh

et al. 2018

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“…An important next step will be to further characterize and substantiate the potential health and socio-economic benefits that vaccination could provide in order to better articulate the potential vaccine impact, and strengthen the value proposition for developing these vaccines [86]. To date, there have been studies describing the economic value of ETEC and Shigella vaccines among travelers and military from high income countries; however, these study populations may not capture the effects of vaccination for children in endemic countries [87]. An investment market assessment on a vaccine for ETEC stand-alone vaccines suggested it may present an estimated annual revenue potential of more than $600 million, 10 years after global launch, based on primarily on travelers and middle-income markets (both public and private), but military and low-income markets were also represented [88].…”

Section: The Potential Public Health Impact Of a Shigella And Etec Vamentioning

confidence: 99%

Considerations for using ETEC and Shigella disease burden estimates to guide vaccine development strategy

Hosangadi

Smith

Giersing

2019

Vaccine

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Enterotoxigenic E. coli (ETEC) and Shigella are enteropathogens causing significant global morbidity and mortality, particularly in low-income countries. No licensed vaccine exists for either pathogen, but candidates are in development, with the most advanced candidates potentially approaching pivotal efficacy testing within the next few years. A positive policy recommendation for introduction of any vaccine, following licensure, depends on evidence of vaccine cost-effectiveness and impact on morbidity and mortality. The mortality estimates for these two pathogens have fluctuated over recent years, which has led to uncertainty in the assessment of their relative public health importance for use in low and middle-income countries. This paper summarizes the various ETEC and Shigella disease burden estimates, based on a review of current literature and informal consultations with leading stakeholders in enteric disease modelling. We discuss the factors that underpin the variability, including differences in the modelling methodology; diagnostic tools used to ascertain diarrheal etiology; epidemiological setting; the data that are available to incorporate; and absolute changes in the total number of diarrheal deaths over time. We consider the further work that will strengthen the evidence needed to support future decision making with respect to recommendations on the relative utility of these vaccines.

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“…Although previous analyses have found NV vaccines to be potentially cost-effective for outbreaks and in children younger than five years old in high-income countries [12, 13], no evaluations have evaluated the benefit of adopting NV vaccines for routine use in the childhood immunization programs of low- and middle-income countries. Here, we evaluate the cost-effectiveness of incorporating a vaccine against NV into the Peruvian national immunization schedule.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of norovirus vaccination in children in Peru

Mirelman

Ballard

Saito

et al. 2015

Vaccine

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Background With candidate norovirus (NV) vaccines in a rapid phase of development, assessment of the potential economic value of vaccine implementation will be necessary to aid health officials in vaccine implementation decisions. To date, no evaluations have been performed to evaluate the benefit of adopting NV vaccines for use in the childhood immunization programs of low- and middle-income countries. Methods We used a Markov decision model to evaluate the cost-effectiveness of adding a two-dose NV vaccine to Peru’s routine childhood immunization schedule using two recent estimates of NV incidence, one for a peri-urban region and one for a jungle region of the country. Results Using the peri-urban NV incidence estimate, the annual cost of vaccination would be $13.0 million, offset by $2.6 million in treatment savings. Overall, this would result in 473 total DALYs averted; 526,245 diarrhea cases averted;153,735 outpatient visits averted; and 414 hospitalizations averted between birth and the fifth year of life. The incremental cost-effectiveness ratio would be $21,415 per DALY averted; $19.86 per diarrhea case; $68.23 per outpatient visit; and $26,298 per hospitalization. Using the higher jungle NV incidence rates provided a lower cost per DALY of $10,135. The incremental cost per DALY with per-urban NV incidence is greater than three times the 2012 GDP per capita of Peru but the estimate drops below this threshold using the incidence from the jungle setting. In addition to the impact of incidence, sensitivity analysis showed that vaccine price and efficacy play a strong role in determining the level of cost-effectiveness. Conclusions The introduction of a NV vaccine would prevent many healthcare outcomes in the Peru and potentially be cost-effective in scenarios with high NV incidence. The vaccine cost-effectiveness model could also be applied to the evaluation of NV vaccine cost-effectiveness in other countries. In resource-poor settings, where NV incidence rates are expected to be higher.

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Economics and financing of vaccines for diarrheal diseases

Cited by 8 publications

References 94 publications

Cost of Caregivers for Treating Hospitalized Diarrheal Patients in Bangladesh

Cost of Caregivers for Treating Hospitalized Diarrheal Patients in Bangladesh

Considerations for using ETEC and Shigella disease burden estimates to guide vaccine development strategy

Cost-effectiveness of norovirus vaccination in children in Peru

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