Can vaccination reduce catastrophic health spending? Evidence from rotavirus disease and vaccine introduction in India: a narrative review

Abstract

In any healthcare system with a high reliance on out-of-pocket spending, treatment for severe rotavirus gastroenteritis can lead to catastrophic health expenditures owing to the costs associated with hospitalization and nonmedical care. While the significant impact of rotavirus vaccination programs on reducing disease incidence, hospitalizations, and childhood mortality is well established, much less attention has been given to their potential impact on the financial burden of diseases that patients, particularly impoverished patients, may experience as a result of the need for medical care. The available literature demonstrates that rotavirus vaccination programs markedly decrease the incidence of severe gastroenteritis and hospitalizations, which are responsible for the high out-of-pocket health expenditures suffered by households. By preventing severe cases and hospitalizations, the vaccines lower direct costs but also indirect costs associated with transportation to and from care facilities and time spent caring for children instead of earning an income. Although no direct estimates currently exist regarding the degree to which the introduction of rotavirus vaccination programs in India reduced catastrophic health expenditures since their introduction, economic evaluations and modeling studies consistently identify that all the financial protective effects of vaccination programs are progressive and disproportionately benefit poorer households. The evidence thus supports the role of rotavirus vaccines not only as lifesaving interventions but also as lifesaving interventions that specifically reduce household financial burdens, promoting universal health coverage and health equity in India.