TY - JOUR
T1 - Estimating the economic impact of pneumococcal conjugate, Haemophilus influenzae type b and rotavirus vaccines in India
T2 - National and state-level analyses
AU - Constenla, D.
AU - Liu, T.
N1 - Funding Information:
Johns Hopkins University’s International Vaccine Access Center ( from The International Clinical Epidemiology Network (INCLEN) Trust International, New Delhi; Prof. Gangandeep Kan, Dr. Jacob John and Dr. J.P. Muliyil from the Community Health and Development Department Christian Medical College (CMC) in Vellore; Dr. N. Arora from the International Clinical Epidemiology Network (INCLEN) Trust International, New Delhi, India, Prof. NK Ganguly from the Translational Health Science and Technology Institute, Jawaharlal Institute of Post Graduate Medical Education and Research, Haryana, India, Prof. Rajesh Kumar and Dr. Shankar Prinja from the Post Graduate Institute of Medical Education and Research (PGIMER) in Chandigarh; Dr. Vijayakumar Moses, Dr. Krishna Rao and Dr. Susmita Chatterjee from the Immunization Technical Support Unit Public Health Foundation of India (PHFI), New Delhi; Dr. Srihari Dutta from The United Nations Children's Fund (UNICEF), New Delhi; Prof. Indrani Gupta from Institute of Economic Growth (IEG), New Delhi; Dr. Madhu Gupta from Institute of Medical Education and Research (IMER), Chandigarh; Dr. Chandrakant Lahariya from National Polio Surveillance Project (NPSP), World Health Organization, New Delhi; Dr. N. K. Sinha from State Health Society (SHS) in Bihar; Prof. Kate O’Brien, Ms. Lois Privor-Dumm, Dr. Anita Shet from Johns Hopkins School of Public Health’s International Vaccine Access Center (IVAC), Baltimore USA, as well as former Johns Hopkins University faculty Dr. Andrea Sutherland. JHU’s IVAC ) wishes to thank the following experts in India for their valuable feedback regarding model inputs: Dr. K. Anand from the All India Institute of Medical Sciences ( AIIMS ), New Delhi; Dr. Manoj Das
Funding Information:
This work was supported by Gavi The Vaccine Alliance, as part of a collaborative effort to make information about vaccine economics more readily available to decision-makers in India.Johns Hopkins University's International Vaccine Access Center (JHU's IVAC) wishes to thank the following experts in India for their valuable feedback regarding model inputs: Dr. K. Anand from the All India Institute of Medical Sciences (AIIMS), New Delhi; Dr. Manoj Das from The International Clinical Epidemiology Network (INCLEN) Trust International, New Delhi; Prof. Gangandeep Kan, Dr. Jacob John and Dr. J.P. Muliyil from the Community Health and Development Department Christian Medical College (CMC) in Vellore; Dr. N. Arora from the International Clinical Epidemiology Network (INCLEN) Trust International, New Delhi, India, Prof. NK Ganguly from the Translational Health Science and Technology Institute, Jawaharlal Institute of Post Graduate Medical Education and Research, Haryana, India, Prof. Rajesh Kumar and Dr. Shankar Prinja from the Post Graduate Institute of Medical Education and Research (PGIMER) in Chandigarh; Dr. Vijayakumar Moses, Dr. Krishna Rao and Dr. Susmita Chatterjee from the Immunization Technical Support Unit Public Health Foundation of India (PHFI), New Delhi; Dr. Srihari Dutta from The United Nations Children's Fund (UNICEF), New Delhi; Prof. Indrani Gupta from Institute of Economic Growth (IEG), New Delhi; Dr. Madhu Gupta from Institute of Medical Education and Research (IMER), Chandigarh; Dr. Chandrakant Lahariya from National Polio Surveillance Project (NPSP), World Health Organization, New Delhi; Dr. N. K. Sinha from State Health Society (SHS) in Bihar; Prof. Kate O'Brien, Ms. Lois Privor-Dumm, Dr. Anita Shet from Johns Hopkins School of Public Health's International Vaccine Access Center (IVAC), Baltimore USA, as well as former Johns Hopkins University faculty Dr. Andrea Sutherland. We also wish to thank former members of the Decade of Vaccine Economics (DoVE) team based at the JHU (S. Ozawa, M. Stack, S. Grewal) who shared early versions of the economic benefits model. We are grateful to the INCLEN Trust International for partnering with the team at IVAC to make the roundtable possible, one of several activities that provided an opportunity to vet and validate the model structures and parameters. Full independence of the methods and control over publication remain with the authors, along with responsibility for any errors.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/12/10
Y1 - 2019/12/10
N2 - Background: To support vaccine decision-making we estimated from the societal perspective the potential health impact and costs averted through immunization with three vaccines – Haemophilus influenzae type b (Hib), pneumococcal conjugate vaccine (PCV) and rotavirus vaccine (RVV). Methods: Based on variability in disease burden, strength of health system and economic status, we selected four states in India: Bihar, New Delhi, Maharashtra and Tamil Nadu. We used secondary data sources to estimate the number of under-5 deaths averted from Hib, pneumococcus and rotavirus in each state and back-calculated the total cases averted. We synthesized available data to estimate the disease burden, treatment cost, caretaker productivity loss and vaccine coverage in each state. A Delphi Survey and roundtable among Indian experts was conducted to reach consensus on model inputs. Results: By scaling up coverage of Hib, PCV and RVV, India could save over US$1 billion (uncertainty range: US$0.9–US$2.4 billion) in economic benefits and avert more than 90,000 needless child deaths each year. An estimated US$1 billion (US$0.9–US$2 billion) or 88% of the total amount of cost savings would be attributable to lost productivity due to premature pneumococcal death. Another US$112.8 million (US$105–297 million), or 10% of the total cost would be accounted by costs related to loss of productivity due to disability as a result of these diseases. Treatment costs of Hib, pneumococcal disease and rotavirus gastroenteritis, would account for US$8.4 million (US$4–12 million) or <1% of the total costs of these diseases. Finally, caretaker productivity loss from seeking care would represent US$1.5 million (US$ 1–4.9 million). Cost savings varied by vaccine, coverage scenarios and states. Conclusions: Hib, PCV and RVV vaccine introduction in India can result in immediate benefits to the government and households in terms of savings.
AB - Background: To support vaccine decision-making we estimated from the societal perspective the potential health impact and costs averted through immunization with three vaccines – Haemophilus influenzae type b (Hib), pneumococcal conjugate vaccine (PCV) and rotavirus vaccine (RVV). Methods: Based on variability in disease burden, strength of health system and economic status, we selected four states in India: Bihar, New Delhi, Maharashtra and Tamil Nadu. We used secondary data sources to estimate the number of under-5 deaths averted from Hib, pneumococcus and rotavirus in each state and back-calculated the total cases averted. We synthesized available data to estimate the disease burden, treatment cost, caretaker productivity loss and vaccine coverage in each state. A Delphi Survey and roundtable among Indian experts was conducted to reach consensus on model inputs. Results: By scaling up coverage of Hib, PCV and RVV, India could save over US$1 billion (uncertainty range: US$0.9–US$2.4 billion) in economic benefits and avert more than 90,000 needless child deaths each year. An estimated US$1 billion (US$0.9–US$2 billion) or 88% of the total amount of cost savings would be attributable to lost productivity due to premature pneumococcal death. Another US$112.8 million (US$105–297 million), or 10% of the total cost would be accounted by costs related to loss of productivity due to disability as a result of these diseases. Treatment costs of Hib, pneumococcal disease and rotavirus gastroenteritis, would account for US$8.4 million (US$4–12 million) or <1% of the total costs of these diseases. Finally, caretaker productivity loss from seeking care would represent US$1.5 million (US$ 1–4.9 million). Cost savings varied by vaccine, coverage scenarios and states. Conclusions: Hib, PCV and RVV vaccine introduction in India can result in immediate benefits to the government and households in terms of savings.
KW - Diarrhea
KW - Economics
KW - India
KW - Meningitis
KW - Pneumonia
KW - Savings
KW - Vaccination
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U2 - 10.1016/j.vaccine.2019.09.084
DO - 10.1016/j.vaccine.2019.09.084
M3 - Article
C2 - 31607600
AN - SCOPUS:85073063328
SN - 0264-410X
VL - 37
SP - 7547
EP - 7559
JO - Vaccine
JF - Vaccine
IS - 52
ER -