Costs of the COVID-19 vaccination programme: estimates from the West Rand district of South Africa, 2021/2022.
Budgeting and planning
COVID-19 vaccination programme
COVID-19 vaccines
Costing analysis
Immunisation economics
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
29 Jul 2024
29 Jul 2024
Historique:
received:
23
01
2024
accepted:
26
06
2024
medline:
30
7
2024
pubmed:
30
7
2024
entrez:
29
7
2024
Statut:
epublish
Résumé
The COVID-19 vaccination programme in South Africa was rolled out in February 2021 via five delivery channels- hospitals, primary healthcare (PHC), fixed, temporary, and mobile outreach channels. In this study, we estimated the financial and economic costs of the COVID-19 vaccination programme in the first year of roll out from February 2021 to January 2022 and one month prior, in one district of South Africa, the West Rand district. Financial and economic costs were estimated from a public payer's perspective using top-down and ingredient-based costing approaches. Data were collected on costs incurred at the national level and from the West Rand district. Total cost and cost per COVID-19 vaccine dose were estimated for each of the five delivery channels implemented in the district. In addition, we estimated vaccine delivery costs which we defined as total cost exclusive of vaccine procurement costs. Total financial and economic costs were estimated at US$8.5 million and US$12 million, respectively; with a corresponding cost per dose of US$15.31 (financial) and US$21.85 (economic). The two biggest total cost drivers were vaccine procurement which contributed 73% and 51% to total financial and economic costs respectively, and staff time which contributed 10% and 36% to total financial and economic costs, respectively. Total vaccine delivery costs were estimated at US$2.1 million (financial) and US$5.7 million (economic); and the corresponding cost per dose at US$3.84 (financial) and US$10.38 (economic). Vaccine delivery cost per dose (financial/economic) was estimated at US$2.93/12.84 and US$2.45/5.99 in hospitals and PHCs, respectively, and at US$7.34/20.29, US$3.96/11.89 and US$24.81/28.76 in fixed, temporary and mobile outreach sites, respectively. Staff time was the biggest economic cost driver for vaccine delivery in PHCs and hospitals while per diems and staff time were the biggest economic cost drivers for vaccine delivery in the three outreach delivery channels. This study offers insights for budgeting and planning of COVID-19 vaccine delivery in South Africa's public healthcare system. It also provides input for cost-effectiveness analyses to guide future strategies for maximizing vaccination coverage in the country.
Sections du résumé
BACKGROUND
BACKGROUND
The COVID-19 vaccination programme in South Africa was rolled out in February 2021 via five delivery channels- hospitals, primary healthcare (PHC), fixed, temporary, and mobile outreach channels. In this study, we estimated the financial and economic costs of the COVID-19 vaccination programme in the first year of roll out from February 2021 to January 2022 and one month prior, in one district of South Africa, the West Rand district.
METHODS
METHODS
Financial and economic costs were estimated from a public payer's perspective using top-down and ingredient-based costing approaches. Data were collected on costs incurred at the national level and from the West Rand district. Total cost and cost per COVID-19 vaccine dose were estimated for each of the five delivery channels implemented in the district. In addition, we estimated vaccine delivery costs which we defined as total cost exclusive of vaccine procurement costs.
RESULTS
RESULTS
Total financial and economic costs were estimated at US$8.5 million and US$12 million, respectively; with a corresponding cost per dose of US$15.31 (financial) and US$21.85 (economic). The two biggest total cost drivers were vaccine procurement which contributed 73% and 51% to total financial and economic costs respectively, and staff time which contributed 10% and 36% to total financial and economic costs, respectively. Total vaccine delivery costs were estimated at US$2.1 million (financial) and US$5.7 million (economic); and the corresponding cost per dose at US$3.84 (financial) and US$10.38 (economic). Vaccine delivery cost per dose (financial/economic) was estimated at US$2.93/12.84 and US$2.45/5.99 in hospitals and PHCs, respectively, and at US$7.34/20.29, US$3.96/11.89 and US$24.81/28.76 in fixed, temporary and mobile outreach sites, respectively. Staff time was the biggest economic cost driver for vaccine delivery in PHCs and hospitals while per diems and staff time were the biggest economic cost drivers for vaccine delivery in the three outreach delivery channels.
CONCLUSION
CONCLUSIONS
This study offers insights for budgeting and planning of COVID-19 vaccine delivery in South Africa's public healthcare system. It also provides input for cost-effectiveness analyses to guide future strategies for maximizing vaccination coverage in the country.
Identifiants
pubmed: 39075487
doi: 10.1186/s12913-024-11251-1
pii: 10.1186/s12913-024-11251-1
doi:
Substances chimiques
COVID-19 Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
857Subventions
Organisme : Bill and Melinda Gates Foundation
ID : Investment ID INV-035464
Organisme : Bill and Melinda Gates Foundation
ID : Investment ID INV-035464
Organisme : Bill and Melinda Gates Foundation
ID : Investment ID INV-035464
Organisme : Bill and Melinda Gates Foundation
ID : Investment ID INV-035464
Organisme : United States Agency for International Development
ID : 72067422D00002/ /72067422F00001
Organisme : United States Agency for International Development
ID : 72067422D00002/ /72067422F00001
Organisme : United States Agency for International Development
ID : 72067422D00002/ /72067422F00001
Organisme : United States Agency for International Development
ID : 72067422D00002/ /72067422F00001
Organisme : United States Agency for International Development
ID : 72067422D00002/ /72067422F00001
Informations de copyright
© 2024. The Author(s).
Références
NDoH. National Department of Health Annual Report 2021/22. Pretoria, South Africa: National Department of Health; 2022. Available from: https://www.health.gov.za/wp-content/uploads/2022/10/2022-Annual-Report-Compressed.pdf .
Daniels RC, Casale D. The impact of COVID-19 in South Africa during the first year of the crisis: evidence from the NIDS-CRAM survey. Dev South Afr. 2022;39(5):605–22.
doi: 10.1080/0376835X.2022.2116408
National Treasury. Estimates of National Expenditure- Health (Vote 18). Pretoria, South Africa: National Treasury; 2022. Available from: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/ https://www.treasury.gov.za/documents/national%20budget/2022/ene/Vote%2018%20Health.pdf .
DGCIS. SA Covid-19 Vaccine Strategy & Rollout: Key Messages. Pretoria, South Africa: Department of Government Communication and Information System; 2021. Available from: https://www.gov.za/sites/default/files/gcis_speech/20210112_SA%20COVID-19%20Vaccine%20Strategy%20Talking%20Points.pdf .
Liu Y, Procter SR, Pearson CAB, Montero AM, Torres-Rueda S, Asfaw E, et al. Assessing the impacts of COVID-19 vaccination programme’s timing and speed on health benefits, cost-effectiveness, and relative affordability in 27 African countries. BMC Med. 2023;21(1):85.
doi: 10.1186/s12916-023-02784-z
pubmed: 36882868
pmcid: 9991879
Griffiths U, Oyatoye I, Asman J, Mandalia N, Brenzel L, Brooks D, et al. Costs and predicted financing gap to deliver COVID-19 vaccines in 133 low- and middle-income countries. New York: UNICEF; 2022.
Nonvignon J, Owusu R, Asare B, Adjagba A, Aun YW, Yeung KHT, et al. Estimating the cost of COVID-19 vaccine deployment and introduction in Ghana using the CVIC tool. Vaccine. 2022;40(12):1879–87.
doi: 10.1016/j.vaccine.2022.01.036
pubmed: 35190206
pmcid: 8813551
Bishai D, Brenzel L, Padula W, editors. Handbook of applied health economics in vaccines. New York: Oxford University Press; 2022.
Vassall A, Sweeney S, Kahn J, Gomez GB. Reference Case for Estimating the Costs of Global Health Services and Interventions. 2017. Available from: https://ghcosting.org/pages/standards/reference_case .
Boonstoppel L, Banks C, Moi F, Vaughan K, Ozaltin A, Brenzel L. How to Conduct an Immunization Campaign Costing Study: Methodological Guidance. Washington DC: ThinkWell; 2021. Available from: https://immunizationeconomics.org/thinkwell-campaign-costing-guidance .
ThinkWell. Campaign costing guidance: Data collection and analysis tools at facility, district, state and national levels for campaign costing studies. 2022. Available from: https://immunizationeconomics.org/thinkwell-campaign-costing-guidance .
Harrison D. Wasted vaccine doses are the result of the right choice by government to prepare for the worst. South Africa: Daily Maverick; 2022. https://www.dailymaverick.co.za/article/2022-09-19-wasted-vaccine-doses-are-the-result-of-the-right-choice-bygovernment-to-prepare-for-the-worst/ .
Department of Public Service and Administration. DPSA 2019 and 2021 Salary Scales. 2021. Available from: https://www.dpsa.gov.za/ .
Drummond MF, Sculpher M, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. 4th ed. Oxford New York: Oxford University Press; 2015. p. 445.
Haacker M, Hallett TB, Atun R. On discount rates for economic evaluations in global health. Health Policy Plan. 2020;35(1):107–14. https://doi.org/10.1093/heapol/czz127 .
NDoH. Health technology assessment methods guide to inform the selection of medicines to the South African national essential medicines list. Pretoria: National Department of Health; 2021.
NDoH. COVID-19 Online Resource & News Portal - Latest Vaccine Statistics. Pretoria: National Department of Health; 2023. Available from: https://sacoronavirus.co.za/latest-vaccine-statistics/ .
Wilkinson T, Sculpher MJ, Claxton K, Revill P, Briggs A, Cairns JA, et al. The international decision support initiative reference case for economic evaluation: an aid to thought. Value Health. 2016;19(8):921–8.
doi: 10.1016/j.jval.2016.04.015
pubmed: 27987641
Orangi S, Kairu A, Ngatia A, Ojal J, Barasa E. Examining the unit costs of COVID-19 vaccine delivery in Kenya. BMC Health Serv Res. 2022;22(1):439.
doi: 10.1186/s12913-022-07864-z
pubmed: 35379227
pmcid: 8978155
Nguyen VM, Moi F, Boonstoppel L, Hoang MV, Duong HT, Vien CC. The cost of delivering COVID-19 vaccines in Vietnam. Geneva: ThinkWell; 2023.
Vaughan K, Smith E, Schütte C, Moi F, Boonstoppel L. The Cost of Delivering COVID-19 Vaccines in Côte d’Ivoire. ThinkWell & Genesis Analytics; 2023. https://thinkwell.global/wp-content/uploads/2023/09/Cost-of-delivering-C19-vaccines-in-Vietnam_final.pdf .
Vaughan K, Griffiths UK, Rankgoane-Pono DG, Mokena OT, Modise M, Moalosi M, et al. Costs of delivering COVID-19 vaccine in Botswana during the height of the pandemic: A retrospective study, 29 November 2023, PREPRINT (Version 1) available at Research Square [ https://doi.org/10.21203/rs.3.rs-3661257/v1 ].
Edoka I, Silal S, Jamieson L, Meyer-Rath G. A cost-effectiveness analysis of South Africa's COVID-19 vaccination programme. Vaccine. 2024;S0264-410X(24)00595-4. https://doi.org/10.1016/j.vaccine.2024.05.036 . Epub ahead of print.