Table 2.
Unit costs (2020 US$) for measles vaccination and treatment by income level of countries
| Cost type (per dose or per case) | Low income | Lower middle income | Upper middle income | Source and notes |
| N&S wastage-adjusted price, RI | Gavi-eligible countries, MR: 0.73/(1–0.15)=0.86 (5-dose vial) 0.66/(1–0.4)=1.10 (10-dose vial) |
Gavi, MR: 0.82/(1–0.15)=0.96 (5-dose vial) 0.66/(1–0.4)=1.10 (10-dose vial) Non-Gavi, MR: 0.87/(1–0.15)=1.02 (5-dose vial) 0.70/(1–0.4)=1.17 (10-dose vial) Non-Gavi, MMR: 4.47/(1–0.01)=4.52 (2-dose vial) |
MR: 2.37/(1–0.01)=2.39 (1–dose vial) 0.69/(1–0.15)=0.81 (5–dose vial) 0.69/(1–0.4)=1.15 (10-dose vial) MMR: 4.00/(1–0.01)=4.04 (1–dose vial) 4.00/(1–0.01)=4.04 (2–dose vial) 1.50/(1–0.15)=1.76 (5–dose vial) 1.50/(1–0.4)=2.50 (10-dose vial) |
MI4A32 1-dose vial: 1% wastage 2-dose vial: 1% wastage 5-dose vial: 15% wastage 10-dose vial: 40% wastage |
| N&S wastage-adjusted price, SIA | Gavi, MR: 0.73/(1–0.1)=0.81 (5-dose vial) 0.66/(1–0.1)=0.73 (10-dose vial) |
Gavi, MR: 0.82/(1–0.1)=0.91 (5-dose vial) 0.66/(1–0.1)=0.73 (10-dose vial) Non-Gavi, MR: 0.87/(1–0.1)=0.97 (5-dose vial) 0.70/(1–0.1)=0.78 (10-dose vial) Non-Gavi, MMR: 4.47/(1–0.01)=4.52 (2-dose vial) |
MR: 2.37/(1–0.01)=2.39 (1–dose vial) 0.69/(1–0.1)=0.77 (5-dose vial) 0.69/(1–0.1)=0.77 (10-dose vial) MMR: 4.00/(1–0.01)=4.04 (1–dose vial) 4.00/(1–0.01)=4.04 (2–dose vial) 1.50/(1–0.1)=1.67 (5-dose vial) 1.50/(1–0.1)=1.67 (10-dose vial) |
MI4A32 1-dose vial: 1% wastage 2-dose vial: 1% wastage 5-dose vial: 10% wastage 10-dose vial: 10% wastage |
| MR-MAP wastage-adjusted price, RI and SIA | 1.29/(1–0.01)=1.30 (lower) 2.92/(1–0.01)=2.95 (upper) |
Gavi: 1.29/(1–0.01)=1.30 (lower) 2.92/(1–0.01)=2.95 (upper) Non-Gavi: 1.48/(1–0.01)=1.49 (lower) 3.36/(1–0.01)=3.39 (upper) |
2.63/(1–0.01)=2.66 (lower) 5.20/(1–0.01)=5.25 (upper) |
1-dose vial: 1% wastage See text A in online supplemental file 1 |
| Vaccine delivery cost, RI | 2.02 plus 0.071 and 0.148 per 1% coverage increase for baseline coverage <80% and ≥80% |
5.11 plus 0.177 and 0.272 per 1% coverage increase for baseline coverage <80% and ≥80% |
6.45 | Levin et al33 Baseline coverage is set as 2020 projected coverage. |
| Vaccine delivery cost, SIA | 0.91 | 1.89 | 1.97 | Levin et al33 |
| Measles treatment cost | 10.9 | 120 | 235 | See text B in online supplemental file 1 |
Unit costs per vaccine dose or per measles case are listed by income level and other factors specific to the type of costs. N&S vaccine procurement prices were extracted from the Market Information for Access Vaccine Purchase Database32 by taking the median prices over 2016–2020, while MR-MAP prices were estimated using the N&S prices plus potential increases in manufacturing costs (text A in online supplemental file 1). Wastage rates were specified by dose package and delivery approaches (RI or SIA) and applied to adjust vaccine price, as: procurement price/(1−wastage rate). Wastage-adjusted vaccine prices are shown in bold values. Vaccine delivery costs are dependent on delivery approaches;33 for RI, marginal delivery cost increases with baseline coverage since more resources are required to reach the underserved populations. Costs for treating measles-related illness were extracted from countries with available data through a literature review (text B in online supplemental file 1).
*Prices from vials with a higher dose were used to ensure the inverse relationship between vial doses and costs.
MAPs, microarray patches; MI4A, Market Information for Access; MMR, measles-mumps-rubella; MR, measles-rubella; N&S, needle and syringe; RI, routine immunisation; SIA, supplementary immunisation activities.