Cholera is both an endemic and epidemic disease in many low and middle-income countries (LMICs). Strategies for cholera control include improving water, sanitation, and hygiene; providing early and effective treatment; and deploying oral cholera vaccine (OCV). This last strategy is relatively new, and countries considering its introduction are interested in knowing the potential cost not only of the vaccine, but also the cost of introduction. This paper describes the costing of OCV introduction in LMICs using a publicly available Excel-based tool known as the CholTool. It includes estimates of delivery cost categories which cover not only the service delivery costs (e.g. vaccine procurement, handling, storage, and transport; vaccination administration, monitoring supervision, and field support), but also the programmatic costs associated with introducing a new vaccine (i.e. microplanning, communication and training materials development, sensitization/social mobilization, and personnel training) to ensure that a comprehensive estimate is provided with health payer perspective. CholTool takes the user through a structured sequence of interlinked modules containing input parameter cells (assumptions), decision cells (variable selections), and formulas (calculations) to produce customized cost estimates based on standardized methods. The tool provides both financial and economic cost estimates, to ensure that both costs are available for consideration. Four examples of applications of CholTool are presented in three countries- one in Ethiopia, two in Malawi and one in Nepal. The estimates of economic delivery cost per dose (including service delivery and programmatic costs) were (in USD 2016): $2.89 in Ethiopia, $3.04 in Malawi1, $3.35 in Malawi2 and $3.06 in Nepal. A cost projection conducted before the campaign using the tool and a retrospective costing using the tool in Nepal resulted in no significant difference between economic delivery costs per dose.

译文

在许多中低收入国家(LMIC),霍乱既是地方病又是流行病。霍乱控制策略包括改善水,环境卫生和个人卫生;提供早期有效的治疗;并部署口服霍乱疫苗(OCV)。最后一种策略是相对较新的,考虑引入该疫苗的国家不仅对疫苗的潜在成本感兴趣,而且也对引入疫苗的成本感兴趣。本文介绍了使用称为CholTool的基于Excel的公开可用工具,在LMIC中引入OCV的成本。它包括交付成本类别的估计值,这些估计不仅涵盖服务交付成本(例如,疫苗的采购,处理,存储和运输;疫苗管理,监测监督和现场支持),还包括与引入新疫苗相关的计划成本(例如,微计划,沟通和培训材料的开发,宣传/社会动员和人员培训),以确保从卫生保健付款人的角度提供全面的估计。 CholTool引导用户完成一系列互连模块的结构化序列,这些模块包含输入参数单元格(假设),决策单元格(变量选择)和公式(计算),以基于标准化方法生成定制的成本估算。该工具提供财务和经济成本估算,以确保可以同时考虑这两种成本。在三个国家/地区介绍了CholTool应用程序的四个示例-一个在埃塞俄比亚,两个在马拉维和一个在尼泊尔。估计每剂经济交付费用(包括服务交付和计划费用)为(2016年美元):埃塞俄比亚为2.89美元,马拉维1为3.04美元,马拉维2为3.35美元,尼泊尔为3.06美元。在运动前使用该工具进行的费用预测以及在尼泊尔使用该工具进行的追溯性费用计算得出,每剂药的经济交付成本之间没有显着差异。

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