VoICE Immunization Evidence: Cost of treating illness
Cost of treating illness
Immunization can offer some financial protection against significant illness treatment costs among the poor.
A study looking at the impact of pneumococcal vaccine introduction and scaling up pneumonia treatment in Ethiopia found that 30-40% of all deaths averted by these interventions would be expected to occur in the poorest wealth quintile. The greatest resulting financial risk protection would also be concentrated among the bottom income quintile.
Illness episodes can cause catastrophic health expenditures to a household, both medical and non-medical out-of-pocket expenditures.
A study in Bangladesh found that families are heavily borrowing or losing assets to be able to bear the cost of pneumonia in their children <5 years of age.
In a 2002 study from Cambodia, households with a dengue patient had to borrow money at high interest rates and lose productive assets (land) to repay debts linked to healthcare costs. Public healthcare cost significantly less than private healthcare but was either not present where people lived or did not have a good reputation.
Families and caretakers may experience acute or lasting loss of wages associated with caring for a child ill with or permanently disabled by a vaccine-preventable disease.
Among families participating in a study in Western Cape, South Africa, 35% of mothers who were previously employed stopped working to care for children who had survived tuberculosis meningitis with permanent disabilities. 19% of families reported experiencing financial loss as a result of caring for these disabled children.
Treatment of vaccine-preventable disease carries a heavy financial toll for health systems and for families.
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, 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 $109 is nearly 4 times the annual per capita expenditure for health in The Gambia.
A 2017 study in Malawi found that the household costs associated with an episode of childhood diarrhea exceeded monthly income in a significant number of cases (in 17% of cases where children were admitted to the hospital, and in 9% of cases where children were treated as outpatients). These costs were significant enough to push families from each income strata below the national poverty line for the month in which the illness took place.
Researchers estimate that vaccinating against 10 diseases in the world’s 94 poorest countries between 2011-2020 will avert $586 Billion in costs of illness (including treatment costs, transportation costs, lost caretaker wages and productivity losses due to death and disability). The 73 Gavi-supported countries account for $544 billion of the treatment costs averted.