VoICE Immunization Evidence: Cost of treating illness

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Cost of treating illness

The Cost of Treating Illness covers the both the economic costs to treat episodes of potentially vaccine-preventable disease, and the power of immunization to help financially protect families from these costs. The evidence on economic costs of illness in this section include both direct medical costs (e.g. medication, healthcare visits) and indirect costs (e.g. transportation, loss of work/productivity). Preventing disease by vaccinating can avert catastrophic health expenditures, thereby alleviating the effects of Poverty, and can relieve the burden on Health Systems by freeing up scarce resources for use in managing other health issues.
7 Key Ideas, 8 Sources
Key Idea

In 41 GAVI-eligible countries, it is estimated that without any rotavirus vaccine (RVV) coverage, an estimated 2.2 million Catastrophic Health Costs (CHC) cases and 600,000 Medical Impoverishment (MI) cases would occur due to rotavirus gastroenteritis. Unfortunately these figures would not significantly decrease under the current immunization forecasts because very few countries have introduced the RVV. However, with the introduction of RVV the number of CHC cases would drop to 1.3 million and MI cases to 400,000, representing a 40% reduction.

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Key Idea

It is estimated that under current vaccine coverage trends in 41 Gavi-eligible countries, enhanced Gavi funding would help to avoid out-of-pocket health expenditures in an amount that surpasses $4.5 billion attributable to measles, $168 million attributable to severe pneumococcal disease and $200 million attributable to severe rotavirus.

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Key Idea

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.

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In a financial risk model analysis of 41 Gavi-eligible countries, the burden of Catastrophic Health Costs (CHC) and Medical Impoverishment (MI) would be greatest in the lowest income populations. With expanded vaccine coverage, the share of prevented cases of measles, pneumococcal disease and rotavirus, in relation to the total number of cases prevented, would be larger in the lowest income populations thereby providing a larger financial risk protection (FRP) to these populations.

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Key Idea

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.

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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.

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In 41 GAVI-eligible countries it is estimated that, in the absence of any measles vaccine use, approximately 18.9 million households would have Catastrophic Health Costs (CHC) attributable to measles. CHC decreases to 3.4 million households in these countries if the current vaccine coverage forecasts is unchanged and decreases to 2.6 million cases if coverage was enhanced with Gavi support. Overall, optimizing vaccine coverage for measles can reduce by approximately 90% the incidence of CHC due to measles disease.

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Key Idea

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.

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Key Idea

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.

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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.

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Key Idea

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.

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A woman carrying vaccines

Search for immunization evidence

The VoICE tool allows you to search for research studies and published evidence based on a topic, location, and disease or vaccine.

Search VoICE