title: Assessing the Potential Cost-Effectiveness of Microneedle Patches in Childhood Measles Vaccination Programs: The Case for Further Research and Development.
abstract: OBJECTIVE
  Currently available measles vaccines are administered by subcutaneous injections and require reconstitution with a diluent and a cold chain, which is resource intensive and challenging to maintain. To overcome these challenges and potentially increase vaccination coverage, microneedle patches are being developed to deliver the measles vaccine. This study compares the cost-effectiveness of using microneedle patches with traditional vaccine delivery by syringe-and-needle (subcutaneous vaccination) in children's measles vaccination programs.
  
  
  METHODS
  We built a simple spreadsheet model to compute the vaccination costs for using microneedle patch and syringe-and-needle technologies. We assumed that microneedle vaccines will be, compared with current vaccines, more heat stable and require less expensive cool chains when used in the field. We used historical data on the incidence of measles among communities with low measles vaccination rates.
  
  
  RESULTS
  The cost of microneedle vaccination was estimated at US$0.95 (range US$0.71-US$1.18) for the first dose, compared with US$1.65 (range US$1.24-US$2.06) for the first dose delivered by subcutaneous vaccination. At 95 % vaccination coverage, microneedle patch vaccination was estimated to cost US$1.66 per measles case averted (range US$1.24-US$2.07) compared with an estimated cost of US$2.64 per case averted (range US$1.98-US$3.30) using subcutaneous vaccination.
  
  
  CONCLUSIONS
  Use of microneedle patches may reduce costs; however, the cost-effectiveness of patches would depend on the vaccine recipients' acceptability and vaccine effectiveness of the patches relative to the existing conventional vaccine-delivery method. This study emphasizes the need to continue research and development of this vaccine-delivery method that could boost measles elimination efforts through improved access to vaccines and increased vaccination coverage.
authors.affiliation: Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Road NE, MS-C18, Atlanta, GA, 30333, USA. bia6@cdc.gov.
authors.forename: Bishwa B
authors.initials: BB
authors.lastname: Adhikari
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Center for Global Health, Atlanta, GA, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Goodson
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Center for Global Health, Atlanta, GA, USA.
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Chu
authors.affiliation: Division of Viral Diseases, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Rota
authors.affiliation: Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, 1600 Clifton Road NE, MS-C18, Atlanta, GA, 30333, USA.
authors.forename: Martin I
authors.initials: MI
authors.lastname: Meltzer
mesh_terms: D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006801:Humans; D007279:Injections, Subcutaneous; D008458:Measles Vaccine / Q000008:administration & dosage* / Q000191:economics*; D008845:Microinjections / Q000191:economics*; D009339:Needles / Q000191:economics*; D057968:Transdermal Patch / Q000191:economics*
chemical_list: D008458:Measles Vaccine