Elsevier, Vaccine, Volume 35, 25 May 2017
Background While our previous work has shown that replacing existing vaccines with thermostable vaccines can relieve bottlenecks in vaccine supply chains and thus increase vaccine availability, the question remains whether this benefit would outweigh the additional cost of thermostable formulations. Methods Using HERMES simulation models of the vaccine supply chains for the Republic of Benin, the state of Bihar (India), and Niger, we simulated replacing different existing vaccines with thermostable formulations and determined the resulting clinical and economic impact. Costs measured included the costs of vaccines, logistics, and disease outcomes averted. Results Replacing a particular vaccine with a thermostable version yielded cost savings in many cases even when charging a price premium (two or three times the current vaccine price). For example, replacing the current pentavalent vaccine with a thermostable version without increasing the vaccine price saved from $366 to $10,945 per 100 members of the vaccine's target population. Doubling the vaccine price still resulted in cost savings that ranged from $300 to $10,706, and tripling the vaccine price resulted in cost savings from $234 to $10,468. As another example, a thermostable rotavirus vaccine (RV) at its current (year) price saved between $131 and $1065. Doubling and tripling the thermostable rotavirus price resulted in cost savings ranging from $102 to $936 and $73 to $808, respectively. Switching to thermostable formulations was highly cost-effective or cost-effective in most scenarios explored. Conclusion Medical cost and productivity savings could outweigh even significant price premiums charged for thermostable formulations of vaccines, providing support for their use.
Article; BCG Vaccine; Benin; Bihar; Computer Simulation; Cost Benefit Analysis; Cost Control; Cost Effectiveness Analysis; Cost-benefit Analysis; Diphtheria; Diphtheria Pertussis Tetanus Vaccine; Drug Cost; Drug Efficacy; Drug Formulation; Drug Stability; Economics; Health Care Cost; Hepatitis B; Hepatitis B Vaccine; Human; Humans; Incidence; India; Infant; Japanese Encephalitis; Japanese Encephalitis Vaccine; Major Clinical Study; Measles; Measles Vaccine; Niger; Oral Poliomyelitis Vaccine; Pertussis; Pneumococcal Infection; Pneumococcus Vaccine; Poliomyelitis; Priority Journal; Rotavirus Infection; Rotavirus Infections; Rotavirus Vaccine; Rotavirus Vaccines; Supply And Distribution; Supply Chains; Temperature; Tetanus; Tetanus Toxoid; Thermostability; Thermostable Vaccines; Tuberculosis; Vaccine; Vaccine Potency; Yellow Fever; Yellow Fever Vaccine; Global