The document analyzes the costs of delivering oral cholera vaccine in Bangladesh. It finds that: 1) The total cost of vaccination was $488,723.73, with vaccine costs accounting for 58.3% ($285,140) and salaries accounting for 23.6% ($115,218.57). 2) The cost per completely vaccinated individual (receiving two doses) was $3.99, while the cost per dose administered was $1.86. 3) Fixed costs made up only 1.4% of total costs, while variable costs like vaccine, salaries, and transport dominated at 98.6% of spending.

1. Cost of Oral Cholera Vaccine
Delivery in Bangladesh: A program
Perspective
Abdur Razzaque Sarker
MHE (Health Economics), MSS (Economics)
Health Economics and Financing Research, icddrb
and
PhD Fellow in Strathclyde University, UK
Email: razzaque.sarker@gmail.com

2. Objectives
 Estimate costs of vaccine delivery related activities
 Estimate “cost per completely vaccinated” in ICVB setting.

3. Methods
 Micro-costing/bottom-up approach applied: All inputs identified,
quantified, valued
 From provider’s/supply-side perspective

4. Vials
delivered to
vaccination
sites
(269,000)
Vials used for
vaccination
(263,399)
Doses
wasted
(5,601)
Vials used to fully
vaccinate people
(2-doses)
(244,778)
Vials used in drop-outs
(18,621)
Usage and wastage of vaccines
4

5. Acquisition cost of cholera vaccine (actual)
Items Quantity Cost (USD)
Total number of vials 350,000 350,000
Freight charge 16,822
Insurance 303
Procurement cost by icddr,b 4,000
Domestic transport 57
Grand total 350,000 371,182
Cost per vial 1.06

6. 6
Cost profile: Total cost of vaccination by fixed and variable cost
Cost component Inputs Cost (USD) Percentage
share
Fixed cost
Cold chain items (Cold box, Vaccine carrier, etc.) 824.52
1.4
Manuals and guidelines 1,527.78
Social mobilization 2,847.22
Training 1,281.28
Accessories (Tooth forceps, Stapler, etc.) 359.61
Total fixed cost 6840.41
Variable cost
Vaccine 285,140.00
98.6
Cold chain items (Icepack and other) 418.14
Transport 29,645.00
salary, remuneration 115,218.57
Communication 14177.31
Waste management 2,394.65
ICVB Card 5,704.17
Vaccination spot setup 6,053.68
Vaccination spot & field office rent 500
Refreshment 19,492.07
Stationeries (Pen, pencil, etc.) 1,239.74
Printing 1,900.00
Total Variable cost 481,883.32
Total Cost for Vaccination 488,723.73 100

7. 7
Description Total Cost # exposed
Cost per
vaccinated
Vaccine cost (vials) 285,140 269,000 1.06
Vaccine delivery activities
(Except vaccine cost)
203,584 263,399 0.77
Per dose (irrespective of complete or
incomplete vaccination)
488,724 263,399 1.86
Completely vaccinated (2 doses) 488,724 122,389 3.99
Cost per vaccinated (US$)

8. Percentage share of total cost
8
Items Cost (USD) Percentage
Accessories (Tooth forceps, Stapler, etc.) 359.61 0.1
Cold Chain related 824.52 0.2
Manuals and guidelines 1527.78 0.3
Social Mobalization 2847.22 0.6
Training 1281.28 0.3
Vaccine 285140 58.3
Cold Chain related 418.14 0.1
Tranport 29645 6.1
Salary 115218.57 23.6
Coomunication 14177.31 2.9
Waste management 2394.65 0.5
ICVB Card 5704.17 1.2
Vaccination spot setup 6053.68 1.2
Rent (Field office and vaccination spot) 500 0.1
Refreshment 19492.07 4.0
Statonnaire 1239.74 0.3
Printing 1900 0.4
Total 488723.74 100.0

9. 9
 Cost of vaccine delivery process is lower than vaccine cost
 Fixed cost is very low compared to variable cost
 The major cost components are ‘vaccine cost’ and ‘salary’
Remarks

10. See in Vaccine Journal

11. THANKS
11
Email: razzaque.sarker@gmail.com