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.
Economics & Return on Investment
Hospitalization for pneumonia in children causes financial burdens for families beyond medical treatment
Three studies in Bangladesh and India found that the direct medical costs for children hospitalized with pneumonia were 27% to 116% of the average monthly income of households. And, while these costs represent a major portion of a family’s monthly income, they don’t include non-medical costs, such as transport and food costs, nor the lost wages of family members who miss work to care for the child.
In rural Malawi, families face financial burdens due to the costs of treating cholera
In rural Malawi, even though medical care for cholera is free-of-charge in the public sector, more than half of families had to borrow money or sell livestock or other assets to compensate for the lost wages of patients or caregivers and other costs (such as for food and transportation) incurred as a result of an episode of cholera.
Measles outbreaks can countries cost millions, highlighting the importance of immunization
A large measles outbreak in the Netherlands in 2013-14 resulted in 2700 cases of disease and cost an estimated US$4.7 million — or US$1,739 per case. Costs included outbreak response (including vaccination and enhanced surveillance), the cost of treatment (primarily hospitalizations), and the loss of productivity among caregivers ($365,000, less than 8% of total costs). Due to the likely under-reporting of the disease, the actual costs could be nearly 20% greater ($5.6 million).
Immunization can prevent costly outbreaks and save money for the healthcare system
A large meningococcal meningitis epidemic in Burkina Faso cost the health system an estimated US$7.1 million, representing nearly 2% of the country’s entire annual health budget.
In this study of a 2007 outbreak, 86% of the health system cost covered a reactive vaccination campaign using older polysaccharide vaccines. Routine vaccination with new, conjugate vaccines are expected to prevent or limit future outbreaks and thus reduce these costs.
Immunization can prevent costly meningitis outbreaks and protect households from financial burden and lost income
A 2006-07 meningococcal meningitis epidemic in Burkina Faso cost households an average of US$90 for each case of meningitis that occurred. These costs — representing nearly 2.5 months of the average per capita income for that year — included direct and indirect costs of treatment and lost income to caretakers.
Rotavirus hospitalizations are costly and result in longer hospital stays compared to non-rotavirus diarrhea
Children with rotavirus experience longer hospital stays than children with non-rotavirus diarrhea. In a study looking at the direct and indirect costs of treating rotavirus in Malaysia, rotavirus hospitalizations cost families 26% of their average total monthly household income, which was significantly higher than the cost for non-rotavirus diarrhea hospitalizations.
Immunization can prevent families from facing financial hardship due to expensive medical treatments
Costs for treatment for rotavirus at a large urban hospital in Malaysia led one third of families to experience catastrophic health expenditures (CHC). When direct and indirect costs of treating rotavirus were considered, almost 9 in 10 families spent more than 10% of their monthly household income on treating rotavirus. In addition, 6% of families were pushed into poverty after paying for treatment.
Immunization helps protect low-income populations from financial burden and prevents diseases like measles and pneumonia
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.
Vaccine coverage in Gavi-eligible countries associated with significant reductions in catastrophic health costs
In 41 Gavi-eligible countries, in the absence of vaccine coverage, the number of Catastrophic Health Costs (CHC) cases caused by measles would be 18.9 million, by severe pneumococcal disease would be 6.6 million and by severe rotavirus disease would be 2.2 million. Expanding vaccine coverage in these countries would reduce the number of cases of CHC due to measles by 90%, due to pneumococcal disease by 30% and due to rotavirus disease by 40%.