In a UK cost-effectiveness analysis, which takes into account herd effect, the budget impact analysis demonstrated that the introduction of a rotavirus vaccine program could pay back between 58-96% of the cost outlay for the program within the first 4 years.
Economics & Return on Investment
Vaccination programs, such as those for rotavirus, have shown short-term return on investment
In an economic evaluation of vaccination against rotavirus conducted in Italy, it was shown that as early as the second year after rotavirus vaccine introduction, the vaccine cost would be more than offset by savings from prevention of disease cases and hospitalizations.
The greatest cost savings come from the scaling up of preventative immunization
Considering both the direct and indirect costs, researchers in the Netherlands estimated that the preventative immunization of Dutch healthcare workers (HCW) against pertussis (to reduce exposure and transmission contributing to outbreaks) results in a return on investment of 4 Euros to every 1 euro invested. This projection assumes an outbreak of pertussis once every 10 years.
Scaling up Rotavirus vaccine coverage heavily averted treatment costs
In a modeled analysis of the economic impact of vaccine use in the world’s 72 poorest countries, for countries included in the analyses from the African region, scaling up coverage of the Rotavirus (RVV) vaccine to 90% was projected to result in more than US$900 million in treatment costs averted.
Medical costs for treating diarrheal disease can drive households below the poverty line
A study modeling the relationship between disease and poverty in Ethiopia found that among the top 20 causes of death in Ethiopia, diarrhea and lower respiratory infections (LRIs) are the top two drivers of medical impoverishment. It is estimated that in 2013, out-of-pocket direct medical costs for diarrheal disease drove an estimated 164,000 households below the poverty line (representing 47% of all the diarrhea cases), and LRIs led to an estimated 59,000 cases of poverty (17% of LRI cases). Of the top 10 health-associated drivers of poverty, four are at least partially vaccine-preventable (1. Diarrhea, 2. LRI, 4. TB. 10. Pertussis).
Vaccination can help prevent impoverishment, especially in low-income populations
In a study modeling the economic impact of immunization in 41 low- and middle-income countries, the authors estimate that 24 million cases of medical impoverishment would be averted through the use of vaccines administered from 2016-2030. The largest proportion of poverty cases averted would occur in the poorest 40% of these populations, demonstrating that vaccination can provide financial risk protection to the most economically vulnerable.
Vaccination can prevent over a million cases of poverty in low- and middle-income countries
Vaccines that can protect against pneumonia – Hib and S. pneumoniae vaccines – can together prevent over 1.25 million cases of poverty over 15 years, found researchers modeling the economic impact of immunization in 41 low- and middle-income countries.
Immunization can prevent medical debts and improverishment, particularly in the poorest populations
A study modeling the economic impact of 10 childhood immunizations in 41 low- and middle-income countries found that the bulk of poverty averted through vaccination occurs in poor populations. For most of the vaccines in the study, at least 40% of the poverty averted would occur in the poorest wealth quintile. Particularly for pneumonia, more than half of the two million deaths averted by pneumococcal and Hib vaccines would occur in the poorest 40% of the population.
Episodes of dengue can cause catastrophic health costs for households
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.
Treatment of vaccine-preventable pneumococcal disease carries a heavy financial toll for health systems and 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, 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.