A new modelling study on the cost-effectiveness of measles and rubella (MR) elimination in low- and middle- income countries (LMICs) has been published in BMJ Global Health. Ann Levin and colleagues used projections of impact of routine and supplementary immunization activities (SIAs) during 2018–2047 for the four scenarios below of ramping up MR vaccination. These were combined with economic parameters to estimate costs and disability-adjusted life years averted under each scenario.
Base Case, where routine vaccination and SIA coverage of children aged <5 years remained at 2018 levels
Continuing Trends, where limited annual improvements based on historic trends in coverage were assumed
Constant Improvement, where coverage rates had linear annual increases of one percentage point and were assumed to ramp up faster than historic trends in Gavi, the Vaccine Alliance-supported countries
Intensified Investment, where coverage had compounding increases of 4.4% annually for all countries and SIAs were conducted more frequently.
The analysis showed that all three scenarios with ramping up coverage above the current trend were more cost-effective in most countries than the 2018 trend for both measles and rubella. When the measles and rubella scenarios were compared with each other, the most cost-effective scenario was likely to be Intensified Investment, the most accelerated one. Even though this scenario is costlier, it averts more cases and deaths and substantially reduces the cost of treatment.
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