cost analysis_ case study
TRANSCRIPT
Cost of Oral Cholera Vaccine Delivery in Bangladesh: A program
Perspective
Abdur Razzaque SarkerMHE (Health Economics), MSS (Economics)
Health Economics and Financing Research, icddrband
PhD Fellow in Strathclyde University, UKEmail: [email protected]
Objectives
Estimate costs of vaccine delivery related activities Estimate “cost per completely vaccinated” in ICVB setting.
Methods
Micro-costing/bottom-up approach applied: All inputs identified, quantified, valued
From provider’s/supply-side perspective
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Vials delivered to vaccination
sites(269,000)
Vials used for vaccination(263,399)
Doses wasted(5,601)
Vials used to fully vaccinate people
(2-doses)(244,778)
Vials used in drop-outs (18,621)
Usage and wastage of vaccines
Acquisition cost of cholera vaccine (actual)Items Quantity Cost (USD)
Total number of vials 350,000 350,000
Freight charge 16,822
Insurance 303
Procurement cost by icddr,b 4,000
Domestic transport 57
Grand total 350,000 371,182
Cost per vial 1.06
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Cost profile: Total cost of vaccination by fixed and variable cost
Cost component Inputs Cost (USD) Percentage share
Fixed cost
Cold chain items (Cold box, Vaccine carrier, etc.) 824.52
1.4 Manuals and guidelines 1,527.78 Social mobilization 2,847.22 Training 1,281.28
Accessories (Tooth forceps, Stapler, etc.) 359.61
Total fixed cost 6840.41
Variable cost
Vaccine 285,140.00
98.6
Cold chain items (Icepack and other) 418.14 Transport 29,645.00 salary, remuneration 115,218.57 Communication 14177.31 Waste management 2,394.65 ICVB Card 5,704.17 Vaccination spot setup 6,053.68 Vaccination spot & field office rent 500 Refreshment 19,492.07 Stationeries (Pen, pencil, etc.) 1,239.74 Printing 1,900.00
Total Variable cost 481,883.32
Total Cost for Vaccination 488,723.73 100
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Description Total Cost # exposed Cost per vaccinated
Vaccine cost (vials) 285,140 269,000 1.06Vaccine delivery activities (Except vaccine cost)
203,584 263,399 0.77
Per dose (irrespective of complete or incomplete vaccination)
488,724 263,399 1.86
Completely vaccinated (2 doses) 488,724 122,389 3.99
Cost per vaccinated (US$)
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Percentage share of total costItems Cost (USD) Percentage
Accessories (Tooth forceps, Stapler, etc.) 359.61 0.1Cold Chain related 824.52 0.2
Manuals and guidelines 1527.78 0.3Social Mobalization 2847.22 0.6Training 1281.28 0.3Vaccine 285140 58.3Cold Chain related 418.14 0.1Tranport 29645 6.1Salary 115218.57 23.6Coomunication 14177.31 2.9Waste management 2394.65 0.5ICVB Card 5704.17 1.2
Vaccination spot setup 6053.68 1.2Rent (Field office and vaccination spot) 500 0.1Refreshment 19492.07 4.0Statonnaire 1239.74 0.3Printing 1900 0.4Total 488723.74 100.0
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Cost of vaccine delivery process is lower than vaccine cost
Fixed cost is very low compared to variable cost
The major cost components are ‘vaccine cost’ and ‘salary’
Remarks
See in Vaccine Journal
