Health economics of rubella: a systematic review to assess the value of rubella vaccination.

Tuesday, 8th of March 2016

BMC Public Health. 2013 Apr 29;13:406. doi: 10.1186/1471-2458-13-406.

Health economics of rubella: a systematic review to assess the value of rubella vaccination.

Babigumira JB¹ Morgan I Levin A.

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Abstract

BACKGROUND:

Most cases of rubella and congenital rubella syndrome (CRS) occur in low- and middle-income countries. The World Health Organization (WHO) has recently recommended that countries accelerate the uptake of rubella vaccination replica uhren deutschland and the GAVI Alliance is now supporting large scale measles-rubella vaccination campaigns. We performed a review of health economic evaluations of rubella and CRS to identify gaps in the evidence base and suggest possible areas of future research to support the planned global expansion of rubella vaccination and efforts towards potential rubella elimination and eradication.

METHODS:

We performed a systematic search of on-line databases and identified articles published between 1970 and 2012 on costs of rubella and CRS treatment and the costs cost-effectiveness or cost-benefit of rubella vaccination. We reviewed the studies and categorized them by the income level of the countries in which they were performed study design and research question answered. We analyzed their methodology data sources and other details. We used these data to identify gaps in the evidence and to suggest possible future areas of scientific study.

RESULTS:

We identified 27 studies: 11 cost analyses 11 cost-benefit analyses 4 cost-effectiveness analyses and 1 cost-utility analysis. Of these 20 studies were conducted in high-income countries 5 in upper-middle income countries and two in lower-middle income countries. We did not find any studies conducted in low-income countries. CRS was estimated to cost (in 2012 US$) between $4200 and $57000 per case annually in middle-income countries and up to $140000 over a lifetime in high-income countries. Rubella vaccination programs including the vaccination of health workers children and women had favorable cost-effectiveness cost-utility or cost-benefit ratios in high- and middle-income countries.

CONCLUSIONS:

Treatment of CRS is costly and rubella vaccination programs are highly cost-effective. However in order for research to support the global expansion of rubella vaccination and the drive towards rubella elimination and eradication additional studies are required in low-income countries to tackle methodological limitations and to determine the most cost-effective programmatic strategies for increased rubella vaccine coverage.