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ISSN: 2157-7560

Journal of Vaccines & Vaccination
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Research Article

Measles Eradication versus Measles Control: An Economic Analysis

David Bishai1*, Benjamin Johns2, Amnesty Lefevre2, Divya Nair1, Emily Simons3# and Alya Dabbagh3#
1Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
2Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
3Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva Switzerland
#The author is a staff member of the World Health Organization. The author alone is responsible for the views expressed in this publication and they do not necessarily represent the decisions, policy or views of the World Health Organization.
Corresponding Author : David Bishai
Department of Population Family and Reproductive Health
Johns Hopkins Bloomberg School of Public Health, Room E4622
615 N. Wolfe St., Baltimore, MD 21205, USA
Tel: +1-410-955-7807
Fax: +1 410-955-2392
E-mail: [email protected]
Received May 15, 2012; Accepted May 22, 2012; Published May 30, 2012
Citation: Bishai D, Johns B, Lefevre A, Nair D, Simons E, et al. (2012) Measles Eradication versus Measles Control: An Economic Analysis. J Vaccines Vaccin S3:002. doi:10.4172/2157-7560.S3-002
Copyright: © 2012 Bishai D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Policy makers choosing whether to eradicate or control measles need to know about the costs of eradication and its alternatives. Methods: This project used a dynamic age-tiered measles transmission model for 6 countries (Bangladesh, Brazil, Colombia, Ethiopia, Tajikistan, and Uganda), which was extrapolated to a linear model that was applied globally. Policy options were constant vaccine coverage at 2010 levels, eradication by 2020, eradication by 2025, 95% mortality reduction by 2015, and 98% mortality reduction by 2020. We compared cumulative discounted societal costs, caseloads, lives, and disability adjusted life years (DALYS) saved with each policy option from 2010 to 2050. Sensitivity analysis tested robustness to parameters. Findings: Strategies to eradicate measles in Bangladesh, Ethiopia, and Uganda cost more than twice as much as control strategies, but have similar costs per DALY averted. More generally, in low and middle income countries that have not yet eliminated measles, the incremental cost effectiveness of control at $20 to $25 per measles death averted is similar to eradication at $22 to $24 per measles death averted. For high income countries that have not yet eliminated measles, eradication by 2020 would prevent deaths and save $800 million more than measles control from 2010-2050 due to averted costs of outbreaks. Interpretation: Measles eradication and measles control are both cost effective. Measles control and eradication have equivalent costs per life saved in low income countries, but high income countries derive savings only if measles is eradicated and imported cases stop.

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