Researchers from the U.S. Centers for Disease Control and Prevention, and the Thailand Ministry of Public Health have conducted a cost-effectiveness analysis of a pre-emptive oral cholera vaccination (OCV) campaign in the Maela refugee camp in Thailand. In the base-case scenario comparing the OCV campaign with no campaign, the team estimated the campaign effect on the cholera incidence rate and case fatality rate (CFR: 0.09%) from a static cohort model and calculated incremental cost-effectiveness ratios for the outcomes of death, disability-adjusted life-years (DALYs), and cases averted.
The OCV campaign economic cost was estimated at US$289,561, 42% of which was attributable to vaccine costs and 58% to service delivery costs. In the base case, the incremental cost was US$1.9 million per death averted, US$1745 per case averted, and US$69,892 per DALY averted. The low multi-year average CFR and incidence of the cholera outbreaks in the Maela camp were key factors associated with the high cost per DALY averted. However, the sensitivity analyses indicated higher cost-effectiveness in a setting with a higher CFR or cholera incidence, indicating when to consider campaign use to reduce the outbreak risk.
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