Cost effectiveness analysis of the oral cholera vaccine in Kenya: the case of Nakuru county

Abstract

Cholera is caused by exposure to a bacterium Vibrio cholerae and may result in acute dehydration or even death in severe cases. It has affected many people in Kenya in recent months and therefore warrants attention. Between December 2014 and July 2015 sixteen counties had experienced a cholera outbreak with varying case fatalities. A total of 4,938 case and 97 deaths were reported. Nakuru County alone had 281 cases out of which 17 people died. This research work sought to establish if using the oral cholera vaccine is cost effective for vulnerable populations by taking a case study of Nakuru County. The cost of treating a cholera incidence was determined from the patient‟s perspective and included direct medical costs, direct non medical costs and indirect productivity losses. The results indicate that of the direct medical costs, the medicines used accounted for the largest cost burden. The Vaccine Introduction Cost Effectiveness Model was then used to determine the cost effectiveness of the intervention. It was found that giving the oral cholera vaccine to 100,000 vulnerable people would cost USD 78,000 and this would avert 1120 cases and 67.98 deaths. The number vaccinated per death averted would be 1471 and per case averted would be 89. The cost to save one life was found to be USD 7526.55 and the total cost per Disability Adjusted Life Year would be 337.21. The GDP per capita for Kenya as at 2014 after rebasing the economy was USD 1246. It was concluded that using the oral cholera vaccine as a preventive measure is very cost effective and is highly recommended since the cost per DALY averted is less than the GDP per capita for Kenya.