In 2007, Brazil experienced an epidemic of rubella with 8,683 confirmed cases of the disease. An economic evaluation of rubella was performed, as well as an outbreak control strategy in the city of Fortaleza in 2007. Two economic evaluations were conducted. The first was a cost-of-illness analysis of the confirmed rubella cases, and the second a cost-effectiveness analysis of two strategies against rubella. The cost-effectiveness of an emergency vaccination (i.e. "cleaning" operation) was compared to providing healthcare for confirmed cases of rubella. The study considered the economic perspectives of the Brazilian government through its Ministry of Health and also the societal perspective, where both direct and indirect costs of prevention and treatment of rubella were considered in the analyses. The total cost-of-illness for the 21 confirmed cases was US$ 1,074.08 (average US$ 51.15) and US$ 7,491.55 (average US$ 356.74) from the government and societal perspectives, respectively. The estimated values for the total cost-of-illness in the country were approximately US$ 444 thousand for the government and US$ 3.1 million to society. The cost-effectiveness analysis showed that the "cleaning" operation was considered dominant over the healthcare provided for rubella cases, producing greater benefits (i.e., less rubella cases) at a lower cost. These results were robust in a series of sensitivity analyses. The cost-effectiveness analysis of the compared alternatives showed that the emergency vaccination strategy was cost-effective and resulted in savings from both the government and societal perspectives.
Brazil; Pharmacoeconomics; Rubella; Outbreaks; Vaccine
