Public finance of pneumococcal vaccine and pneumonia treatment in Ethiopia: - an extended...
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![Page 1: Public finance of pneumococcal vaccine and pneumonia treatment in Ethiopia: - an extended cost-effectiveness analysis Kjell Arne Johansson Department of.](https://reader035.fdocuments.us/reader035/viewer/2022070605/5a4d1ad87f8b9ab059973a89/html5/thumbnails/1.jpg)
Public finance of pneumococcal vaccine and pneumonia treatment in Ethiopia: - an extended cost-effectiveness analysis
Kjell Arne Johansson Department of global and public health
University of [email protected]
Stephane VerguetDepartment of Global Health
University of Washington
![Page 2: Public finance of pneumococcal vaccine and pneumonia treatment in Ethiopia: - an extended cost-effectiveness analysis Kjell Arne Johansson Department of.](https://reader035.fdocuments.us/reader035/viewer/2022070605/5a4d1ad87f8b9ab059973a89/html5/thumbnails/2.jpg)
Plan• Burden of pneomococcal disease and pneumonia in Ethiopia
• Health benefits across income groups
• Costs of public finance
• Income equivalent equity weights
• Private expenditures averted
• Financial protection
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Objective
• To evaluate the expected financial protection and health gains of two publicly financed child health programs in Ethiopia, pneumonia treatment and pneumococcal vaccination
• Averages will be spread across income groups
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DISEASE BURDEN AND DEMANDBACKGROUND
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Disease burden and income distribution in Ethiopia
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Utilization of health services
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Total costs of public finance of both interventions (close to 40% coverage)
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Deaths avertedper 1,000,000 US$:
PCV (0.2 US$): 3010PCV (3.5 US$): 540Antibiotics: 560
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Income equivalent health gains- distributive weights applied
Ref: Fleurbaey M et al. Health Econ. 2012
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Fair evaluation of PCV/antibiotics- income equivalent weights applied
Equivalent lives saved per 1,000,000 US$:
PCV (0.2 US$): 3010 3060 (2%)Antibiotics: 560 660 (18%)
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Financial protection
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Household expenditures avertedper 1,000,000 US$:
PCV: 180,000 US$Antibiotics: 160,000 US$
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Utility curve for financial protection
U(y) = (y^(1-r) / (1-r)
Ref. Finkelstein A., McKnight R. Journal of Public Economics. 2008; McClellan M, Skinner J, Journal of Public Economics. 2006;
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Expected value of incomeE(y) = (1 - I0(y))y + I0(y) (y - Ctreatment)Expected value of utilityEu(y) = (1 - I0(y))u(y) + I0(y) u(y - Ctreatment)Insurance value / certainty equivalentV(y) = E(y) – u-1[Eu(y)]
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Financial risk protection
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Health gains & financial protection - per $1M spent
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Expected distribution of health gains & financial protection (per $1M spent)
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Summary• Health distribution
PCV saves most lives. Equivalent health gains improves the expected utilities the most for pneumonia treatment by giving more weight to health benefits to the poor
• Financial protectionPneumonia treatment improves financial protection the most, especially for the poor
• Normative problemSave the most lives (PCV) vs. improving financial protection the most (pneumonia treatment)