VoICE Immunization Evidence: Cost of treating illness
Treatment of vaccine-preventable disease carries a heavy financial toll for health systems and for families.
Key Evidence: In a global review of the costs of treating childhood pneumonia, the average costs of a hospitalized case of pneumonia in children under five years of age was US$243 in primary or secondary hospitals in low- and middle-income countries (ranging from US$40 – US$563) and US$559 in tertiary hospitals (ranging from US$20 – US$1,474). In high-income countries, the cost of hospitalized cases averaged US$2,800 in primary or secondary hospitals and more than US$7,000 in tertiary hospitals. Note that in most of these studies, only direct medical costs were included and thus total costs – including non-medical costs and lost wages – would be considerably higher.
Zhang S, Sammon PM, King I, Andrade AL et al. 2016. Cost of management of severe pneumonia in young children: systematic analysis. Journal of Global Health. 6(1).
Key Evidence: In rural Malawi, where medical care for cholera is free-of-charge, cholera still cost households, on average, US$66 in lost wages of the patient or caregiver and direct, non-medical costs, such as food and transportation. The direct cost to health facilities was $60 per case, twice as much as the 2016 per capita health budget for Malawi that year.
From the VoICE editors: Data on per capita health expenditures by country can be found in the WHO Health Expenditures database here: http://apps.who.int/nha/database/Select/Indicators/en
Ilboudo PG, Huang XX, Ngwira B et al. 2017. Cost-of-illness of cholera to households and health facilities in rural Malawi. PLOS One. 12(9).
Key Evidence: In a study in The Gambia – a setting where healthcare is free of charge to patients – pneumococcal disease nonetheless placed a heavy financial burden on families seeking treatment before arrival at the hospital, with families paying for transportation costs, drugs, diagnostic tests and even burial in the case of death. 50-80% of the cost of treating an episode of pneumococcal disease was born by the health system, which still left families to cover a cost up to 10 times their average daily household budget. In addition the estimated treatment cost for inpatient pneumonia of US$109 is nearly 4 times the annual per capita expenditure for health in The Gambia.
Usuf, E., Mackenzie, G., Sambou, S., et al 2016. The economic burden of childhood pneumococcal diseases in The Gambia. Effectiveness and Resource Allocation. 14:4.
Key Evidence: In Malawi, in 17% of cases where children were admitted to the hospital, and in 9% of cases where children were treated as outpatients for diarrhea, household costs associated with treating that episode, exceeded monthly income in a significant number of cases. The costs were significant enough to push families from each income level below the national poverty line for the month in which the illness occurred.
Hendrix, N., Bar-Zeev, N., Atherly, D., et al 2017. The economic impact of childhood acute gastroenteritis on Malawian families and the healthcare system. BMJ open. 7(9), p.e017347.