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. 2024 Nov 21;14(11):e084207.
doi: 10.1136/bmjopen-2024-084207.

Cost of delivering childhood RSV prevention interventions to the health system in Kenya: a prospective analysis

Ranju Baral  1 , Elkanah Otiang  2 , Joseph Odiyo  3 , Bryan O Nyawanda  4 , Joyce U Nyiro  5 , Patrick Munywoki  5 , Rose E Jalang'O  6 , Clint Pecenka  7
Affiliations

Cost of delivering childhood RSV prevention interventions to the health system in Kenya: a prospective analysis

Ranju Baral et al. BMJ Open. .

Abstract

Objectives: To evaluate the cost of delivering childhood respiratory syncytial virus (RSV) prevention interventions to the health system in Kenya.

Design: A prospective (cost projection) activity-based costing study.

Setting: Kenya, national introduction of interventions.

Participants: Not applicable.

Interventions: A single-dose RSV maternal vaccine and a single-dose, long-acting monoclonal antibody (mAb).

Primary and secondary outcome measures: Cost per eligible target population; cost per dose administered; non-commodity cost of delivery. Costs are reported in 2023 USD.

Results: RSV interventions are expected to be delivered using existing systems: maternal vaccine using the antenatal care platform and the mAb delivered similar to existing birth dose vaccines. Assuming a price of US$3 per dose (for both interventions) and baseline coverage rates averaging 50% for the maternal vaccine and 86% for the mAb, the estimated cost of delivering maternal vaccine was US$1.74 (financial) and US$6.60 (economic) per vaccinated woman, and the cost of delivering mAbs was US$1.56 (financial) and US$6.27 (economic) per vaccinated child. Excluding commodity cost, the cost of delivering maternal vaccine was US$1.32 (financial) and US$2.72 (economic) and that for mAb was US$1.23 (financial) and US$2.48 (economic). Cost differences between the two interventions are driven by the anticipated baseline coverage. Health worker training, service delivery and programme planning and coordination were major cost drivers.

Conclusion: This study presents the prospective cost of new RSV intervention introduction and delivery in low-income and middle-income country settings, which is largely unknown. Cost estimates incorporate anticipated health system strengthening activities needed to deliver the future RSV interventions. These cost estimates support country-level and global-level decision-makers evaluating implementation feasibility and intervention affordability.

Keywords: health economics; infectious diseases; respiratory infections.

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Conflict of interest statement

Competing interests: RB and CP were employed by PATH while engaged in this research. REJ is the head of the national vaccines and immunisation programme in Kenya.

Figures

Figure 1
Figure 1. One-way sensitivity of unit cost estimates for RSV maternal vaccine introduction and delivery. RSV, respiratory syncytial virus.
Figure 2
Figure 2. One-way sensitivity of unit cost estimates for RSV mAb introduction and delivery. mAb, monoclonal antibody; RSV, respiratory syncytial virus.
See this image and copyright information in PMC

References

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