Public finance of rotavirus vaccination in India and Ethiopia

An extended cost-effectiveness analysis

Stéphane Verguet, Shane Murphy, Benjamin Anderson, Kjell Arne Johansson, Roger Glass, Richard Rheingans

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background: An estimated 4% of global child deaths (approximately 300,000 deaths) were attributed to rotavirus in 2010. About a third of these deaths occurred in India and Ethiopia. Public finance of rotavirus vaccination in these two countries could substantially decrease child mortality and also reduce rotavirus-related hospitalizations, prevent health-related impoverishment and bring significant cost savings to households. Methods: We use a methodology of 'extended cost-effectiveness analysis' (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. We measure program impact along four dimensions: 1) rotavirus deaths averted; 2) household expenditures averted; 3) financial risk protection afforded; 4) distributional consequences across the wealth strata of the country populations. Results: In India and Ethiopia, the program would lead to a substantial decrease in rotavirus deaths, mainly among the poorer; it would reduce household expenditures across all income groups and it would effectively provide financial risk protection, mostly concentrated among the poorest. Potential indirect benefits of vaccination (herd immunity) would increase program benefits among all income groups, whereas potentially decreased vaccine efficacy among poorer households would reduce the equity benefits of the program. Conclusions: Our approach incorporates financial risk protection and distributional consequences into the systematic economic evaluation of vaccine policy, illustrated here with the case study of public finance for rotavirus vaccination. This enables selection of vaccine packages based on the quantitative inclusion of information on equity and on how much financial risk protection is being bought per dollar expenditure on vaccine policy, in addition to how much health is being bought.

Original languageEnglish (US)
Pages (from-to)4902-4910
Number of pages9
JournalVaccine
Volume31
Issue number42
DOIs
StatePublished - Oct 1 2013

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public finance
Ethiopia
Rotavirus
cost effectiveness
Cost-Benefit Analysis
India
Vaccination
vaccination
death
Vaccines
Health Expenditures
vaccines
household expenditure
households
income
Herd Immunity
Child Mortality
Cost Savings
Health
economic analysis

All Science Journal Classification (ASJC) codes

  • Molecular Medicine
  • Immunology and Microbiology(all)
  • veterinary(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Public finance of rotavirus vaccination in India and Ethiopia : An extended cost-effectiveness analysis. / Verguet, Stéphane; Murphy, Shane; Anderson, Benjamin; Johansson, Kjell Arne; Glass, Roger; Rheingans, Richard.

In: Vaccine, Vol. 31, No. 42, 01.10.2013, p. 4902-4910.

Research output: Contribution to journalArticle

Verguet, Stéphane ; Murphy, Shane ; Anderson, Benjamin ; Johansson, Kjell Arne ; Glass, Roger ; Rheingans, Richard. / Public finance of rotavirus vaccination in India and Ethiopia : An extended cost-effectiveness analysis. In: Vaccine. 2013 ; Vol. 31, No. 42. pp. 4902-4910.
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