A cost-effectiveness study of the Intensified Mission Indradhanush (IMI), a large-scale periodic intensification of routine immunization in India in 2017-2018, found that it was both impactful and cost-effective for improving vaccination coverage, though there is a high degree of uncertainty in the results. Researchers sampled 40 districts, and measured the incremental economic cost of IMI using primary data, and used controlled interrupted time-series regression to estimate incremental vaccination doses delivered.
In sampled districts, IMI was found to have an estimated incremental cost of 2021US$13.7 million from an immunization program perspective and increased vaccine delivery by an estimated 2.2 million doses over a 12-month period, averting an estimated 1,413 deaths. The incremental cost from a program perspective was $6.21 per dose ($2.80 to dominated), $82.99 per zero-dose child reached ($39.85 to dominated), $327.63 ($147.65 to dominated) per disability-adjusted life year (DALY) averted, $360.72 ($162.56 to dominated) per life-year saved, and $9,701.35 ($4,372.01 to dominated) per under-five death averted.
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