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Yeung KHT, Kim E, Yap WA, Pathammavong C, Franzel L, Park YL, Cowley P, Griffiths UK, Hutubessy RCW. Estimating the delivery costs of COVID-19 vaccination using the COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool: the Lao People's Democratic Republic experience. BMC Med 2023; 21:248. [PMID: 37424001 PMCID: PMC10332011 DOI: 10.1186/s12916-023-02944-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/15/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND The COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool was developed to assist countries to estimate incremental financial costs to roll out COVID-19 vaccines. This article describes the purposes, assumptions and methods used in the CVIC tool and presents the estimated financial costs of delivering COVID-19 vaccines in the Lao People's Democratic Republic (Lao PDR). METHODS From March to September 2021, a multidisciplinary team in Lao PDR was involved in the costing exercise of the National Deployment and Vaccination Plan for COVID-19 vaccines to develop potential scenarios and gather inputs using the CVIC tool. Financial costs of introducing COVID-19 vaccines for 3 years from 2021 to 2023 were projected from the government perspective. All costs were collected in 2021 Lao Kip and presented in United States dollar. RESULTS From 2021 to 2023, the financial cost required to vaccinate all adults in Lao PDR with primary series of COVID-19 vaccines (1 dose for Ad26.COV2.S (recombinant) vaccine and 2 doses for the other vaccine products) is estimated to be US$6.44 million (excluding vaccine costs) and additionally US$1.44 million and US$1.62 million to include teenagers and children, respectively. These translate to financial costs of US$0.79-0.81 per dose, which decrease to US$0.6 when two boosters are introduced to the population. Capital and operational cold-chain costs contributed 15-34% and 15-24% of the total costs in all scenarios, respectively. 17-26% went to data management, monitoring and evaluation, and oversight, and 13-22% to vaccine delivery. CONCLUSIONS With the CVIC tool, costs of five scenarios were estimated with different target population and booster dose use. These facilitated Lao PDR to refine their strategic planning for COVID-19 vaccine rollout and to decide on the level of external resources needed to mobilize and support outreach services. The results may further inform inputs in cost-effectiveness or cost-benefit analyses and potentially be applied and adjusted in similar low- and middle-income settings.
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Affiliation(s)
- Karene Hoi Ting Yeung
- Department of Immunization, Vaccines and Biologicals, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland
| | - Eunkyoung Kim
- World Health Organization, Lao People's Democratic Republic, 125 Saphanthong Road, Unit5, Ban Saphanthongtai, Sisattanak District, P.O.Box 343, Vientiane Capital, Lao People's Democratic Republic
| | - Wei Aun Yap
- Quanticlear Solutions Sdn. Bhd, Kuala Lumpur, Malaysia
| | - Chansay Pathammavong
- Mother and Child Health Center, National Immunization Programme, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
| | - Lauren Franzel
- Department of Immunization, Vaccines and Biologicals, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland
| | - Yu Lee Park
- World Health Organization, Lao People's Democratic Republic, 125 Saphanthong Road, Unit5, Ban Saphanthongtai, Sisattanak District, P.O.Box 343, Vientiane Capital, Lao People's Democratic Republic
| | - Peter Cowley
- Department of Health Governance and Financing, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland
| | | | - Raymond Christiaan W Hutubessy
- Department of Immunization, Vaccines and Biologicals, World Health Organization, 20, Avenue Appia, 1211, Geneva 27, Switzerland.
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Debellut F, Mkisi R, Masoo V, Chisema M, Mwagomba D, Mtenje M, Limani F, Mategula D, Zimba B, Pecenka C. Projecting the cost of introducing typhoid conjugate vaccine (TCV) in the national immunization program in Malawi using a standardized costing framework. Vaccine 2022; 40:1741-1746. [PMID: 35153097 PMCID: PMC8917043 DOI: 10.1016/j.vaccine.2022.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/19/2022]
Abstract
Background There is a substantial typhoid burden in sub-Saharan Africa, and TCV has been introduced in two African countries to date. Decision-makers in Malawi decided to introduce TCV and applied for financial support from Gavi, the Vaccine Alliance in 2020. The current plan is to introduce TCV as part of the national immunization program in late 2022. The introduction will include a nationwide campaign targeting all children aged 9 months to 15 years. Following the campaign, TCV will be provided through routine immunization at 9 months. This study aims to estimate the cost of TCV introduction and recurrent delivery as part of the national immunization program. Methods This costing analysis is conducted from the government's perspective and focuses on projecting the incremental cost of TCV introduction and delivery for Malawi’s existing immunization program before vaccine introduction. The study uses a costing tool developed by Levin & Morgan through a partnership between the International Vaccine Institute and the World Health Organization and leverages primary and secondary data collected through key informant interviews with representatives of the Malawi Expanded Programme on Immunization team at various levels. Results The total financial and economic costs of TCV introduction over three years in Malawi are projected to be US$8.5 million and US$29.8 million, respectively. More than two-thirds of the total cost is made up of recurrent costs. Major cost drivers include the procurement of vaccines and injection supplies and service delivery costs. Without vaccine cost, we estimate the cost per child immunized to be substantially lower than US$1. Discussion Findings from this analysis may be used to assess the economic implications of introducing TCV in Malawi. Major cost drivers highlighted by the analysis may also inform decision-makers in the region as they assess the value and feasibility of TCV introduction in their national immunization program.
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Affiliation(s)
- Frédéric Debellut
- Center for Vaccine Innovation and Access, PATH, Geneva, Switzerland.
| | - Rouden Mkisi
- Center for Vaccine Innovation and Access, PATH, Lilongwe, Malawi
| | - Vincent Masoo
- Health Management Information System, Mzuzu Central Hospital, Mzuzu, Malawi
| | - Mike Chisema
- Expanded Programme on Immunization, Ministry of Health, Lilongwe, Malawi
| | - Dennis Mwagomba
- Expanded Programme on Immunization, Ministry of Health, Lilongwe, Malawi
| | - Mphatso Mtenje
- Expanded Programme on Immunization, Ministry of Health, Lilongwe, Malawi
| | - Fumbani Limani
- Malawi-Liverpool-Wellcome Trust/College of Medicine, Chichiri, Blantyre, Malawi
| | - Donnie Mategula
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital Blantyre, Malawi
| | | | - Clint Pecenka
- Center for Vaccine Innovation and Access, PATH, Seattle, USA
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Costs of providing COVID 19-protective measures during routine immunisation in lower-income countries? PHARMACOECONOMICS & OUTCOMES NEWS 2021; 885:4. [PMID: 34429576 PMCID: PMC8377326 DOI: 10.1007/s40274-021-07946-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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