Publication: Cost-effectiveness and Financial Consequences of New Vaccine Introduction in Pakistan
Date
2011-10
ISSN
Published
2011-10
Author(s)
Brenzel, Logan
Sanderson, Colin
Galayda, Victor
Masud, Tayyeb
Haq, Inaaml ul
Abstract
Pakistan has one of the highest infant mortality
rates in the world, and over 50 percent of deaths in
post-neonatal children are attributable to pneumonia,
diarrhea, or meningitis diseases that can be prevented
through vaccination. The purpose of the study is to compare
the cost-effectiveness and financial implications of
introducing pneumococcal (PCV-10), rotavirus (Rota-Teq), and
Homophiles influenza type B (Hib) vaccines in Pakistan. The
cost-effectiveness analysis was conducted using the Tri-Vac
model, which is a static model that estimates the burden of
disease and the costs of treatment and for the immunization
program of children up to five years old in ten annual birth
cohorts (2010 to 2019). Sensitivity analyses were conducted
testing key assumptions related to disease burden, vaccine
efficacy, and vaccine cost. The analysis of financial
implications included a projection of cold chain needs and
costs associated with the introduction of each new vaccine,
as well as the financial outlays required by the government.
Sensitivity testing was also conducted on major assumptions.
All three vaccines were found to be cost-effective, with Hib
vaccine the most cost-effective option at $22 per
disability-adjusted-life-year (DALY). The cost-effectiveness
figures for PCV and rotavirus vaccines were $225/DALY and
$201/DALY, respectively. Sensitivity testing did not
significantly alter the results. The combined financial
requirement for the three new vaccines would peak in 2017 if
GAVI assistance reduced to five rather than eight years
($213m). This cost would account for 40 percent of national
immunization expenditures, and 15 percent of government
health expenditures. Required cold chain investments would
be small relative to the expenditure on vaccines, and
represents a good return on investment. While the investment
would be worthwhile from an economic perspective,
introducing all three vaccines in Pakistan will present
financial challenges unless overall health spending
increases. Careful consideration needs to be given to
long-term financing after GAVI support ends.
Citation
“Brenzel, Logan; Sanderson, Colin; Galayda, Victor; Masud, Tayyeb; Haq, Inaaml ul. 2011. Cost-effectiveness and Financial Consequences of New Vaccine Introduction in Pakistan. Health, Nutrition and Population (HNP)
discussion paper;. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/16456ac5-bfb2-552e-8950-293688af237e License: CC BY 3.0 IGO.”