PIN21 A Review of Economic Studies of Rubella and Rubella Vaccination

Abstract

OBJECTIVES: To examine the economic evidence base, identify gaps in the evidence, and propose potential areas of future enquiry into the economics of rubella, congenital rubella syndrome (CRS) and rubella vaccination to support the planned global expansion of rubella-containing vaccine (RCV) and the push towards potential rubella elimination and eradication. METHODS: A MEDLINE search was conducted of articles published between 1980 and 2010 on costs of rubella and CRS treatment and the costs, cost-effectiveness or cost-benefit of rubella vaccination. The design and results of studies were reviewed and categorized by the country income level. Gaps in the evidence of the costs of rubella and CRS and cost-effectiveness of rubella vaccination and the potential for rubella eradication were identified. RESULTS: Twenty-five studies were identified. Of the nineteen studies conducted in high-income countries, 5 were cost analyses, 3 were cost-effectiveness analyses and 11 were cost-benefit analyses. Of the five studies conducted in upper middle-income countries, four were cost analyses and one was a cost-benefit study. A single study was conducted in a lower middle-income country and was a cost-benefit analysis. No studies were conducted in low-income countries. In the review, CRS was estimated to cost between $1,994 and $13,482 per case annually or between $50,000 and $63,990 lifetime in middle-income countries and $98,734 lifetime in high-income countries. The review also found that rubella vaccination programs had favorable cost-effectiveness, cost-utility, or cost-benefit ratios in high-income countries and middle-income countries. CONCLUSIONS: Rubella is costly and rubella vaccination programs are highly cost-effective. However, in order for research to support the drive towards rubella elimination and eradication, additional studies are required in low-income countries, to tackle methodological limitations, and determine the most cost-effective strategies for rubella vaccination.