Cost-effectiveness and budget impact of malaria, measles, and meningitis vaccines in Africa: a scoping review.

OBJECTIVES

Despite the availability of malaria, measles, and meningitis vaccines in Africa, limited evidence on their cost-effectiveness and budget impact hinders informed policy decisions and sustainable allocation of scarce healthcare resources. We conducted a scoping review to synthesize available evidence on the cost-effectiveness and budget impact analysis of malaria, measles, and meningitis vaccines in Africa.

METHODS

A literature search of PubMed, HINARI, and EBSCO Host databases was conducted to identify studies published in English between 2004 and 2024. The review was conducted and reported according to PRISMA-ScR guidelines. Eligible studies focused on the cost-effectiveness or budget impact of malaria, measles, and meningitis vaccines in African countries. Retrieved articles were subjected to title, abstract, and full text screening to determine if they met the eligibility criteria. Data was extracted from included papers, and incremental cost-effectiveness ratios were extracted or computed, when feasible, in 2024 US dollars.

RESULTS

Forty-one (41) of the 885 retrieved articles were included in this review. The costing approach varied, with most studies valuing only direct costs. Transmission, mathematical, and Markov models were the predominant cost-effectiveness modelling methods. The cost per fully vaccinated child for malaria and measles vaccines ranged from US$4.20 to $52.35 and US$1.66 to $4.31, respectively. The costs per disability-adjusted years (DALYs) averted for malaria, measles, and meningitis vaccines ranged from US$22.63 to US$3314.01, US$1.60 to US$1239.35, and US$66.64 to US$4586.72, respectively. Most studies found that the three vaccines were more cost-effective than no intervention or other public health interventions. The budget impact of introducing the malaria vaccine in 41 African countries is about US$185 million.

CONCLUSION

There is limited evidence on the cost-effectiveness of the malaria, measles, and meningitis vaccines in Africa. The vaccines were largely cost-effective in Africa, although the budget impact of malaria vaccine is substantial.