Cost-effectiveness and budget impact analyses of Typhoid Vi capsular polysaccharide vaccination in Indonesia

Typhoid fever has a substantial economic impact in developing countries, including in Indonesia. As the most cost-effective intervention to prevent typhoid fever, vaccination has not yet been introduced in the country. This study aimed to analyse the cost-effectiveness and budget impact of typhoid vaccination strategies, focusing on high-burden regions in Indonesia. This study applied a top-down cost analysis method by collecting costs from various sources to estimate incremental cost-effectiveness ratio and to analyse the impact of this new program in a time horizon of six years within the scenario. In the first five years, the typhoid vaccine will be introduced only in high-risk areas, with nationwide vaccination starting in the sixth year. The results showed that vaccination can prevent 158,276 cases and 352 deaths in six years. It also could save treatment costs up to $10,655,063, resulting in a cost-saving intervention. Compared with the routine immunization budget, the total budget for typhoid vaccination would be 0.11%, 0.15%, 0.18%, 0.86%, 1.21% and 2.11%. To conclude, the nationwide typhoid vaccination in Indonesia is a cost-saving and affordable intervention since the required budget was only 2.11% of Indonesia’s total routine immunization budget.