Malaria vaccines | NITAG RESOURCE CENTER

Cost-effectiveness ratio

Mathematical models estimate that introduction of RTS,S/AS01 and R21/Matrix-M into childhood immunization programmes could have a substantial impact on reducing malaria cases and deaths in endemic settings in Africa, with greater public health impact and cost effectiveness at higher levels of transmission. ^{Go to footnote 11}

At assumed RTS,S/AS01 vaccine prices between US$5-10 per dose, incremental cost-effectiveness ratios (ICERs) were generally less than US$ 100 per disability adjusted life year (DALY) averted at moderate and high transmission intensities (>20% P.falciparum parasite rate among children 2-10 years of age (PfPR2-10)) and across age-based, seasonal and hybrid delivery approaches ^{Go to footnote 22, Go to footnote 33, Go to footnote 44} . At an assumed price of US$ 3 per dose and 20% PfPR2-10, R21/Matrix-M ICERs ranged between US$ 30–48 per DALY averted depending on a range of delivery approaches, transmission settings, and intensities. ^{Go to footnote 55, Go to footnote 66} Estimates were more uncertain in low or very low transmission intensities (<10% PfPR2-10). ^{Go to footnote 77}

Cost–effectiveness varies considerably by several factors, including, the burden of disease, seasonality, malaria vaccine effectiveness, indirect effects, vaccination coverage, vaccine price, delivery costs, delivery approaches, and schedules. Caution is recommended when comparing estimates of cost-effectiveness for different interventions evaluated by different methods, with different outcome measures and time intervals, and in different contexts (e.g., with different concurrent health interventions and standards of care).

Sources

Go back to footnote reference 1
World Health Organization (2024). Malaria vaccines: WHO position paper, May 2024. Wkly Epidemiol Rec. 99(19):225–248 (https://www.who.int/publications/i/item/who-wer-9919-225-248, accessed 13 May 2026).
Go back to footnote reference 2
World Health Organization (2024). Malaria vaccines: WHO position paper, May 2024. Wkly Epidemiol Rec. 99(19):225–248 (https://www.who.int/publications/i/item/who-wer-9919-225-248, accessed 13 May 2026).
Go back to footnote reference 3
Penny MA, Verity R, Bever CA, Sauboin C, Galactionova K et al. Public health impact and cost-effectiveness of the RTS,S/AS01 malaria vaccine: a systematic comparison of predictions from four mathematical models. Lancet. 2016;387(10016):367–375. doi:10.1016/S0140-6736(15)00725-4.
Go back to footnote reference 4
World Health Organization (2021). Modelled public health impact and cost effectiveness estimates of RTS,S/AS01 malaria vaccine in perennial and seasonal settings. Geneva: World Health Organization (https://zenodo.org/records/6395841, accessed 13 May 2026).
Go back to footnote reference 5
World Health Organization (2024). Malaria vaccines: WHO position paper, May 2024. Wkly Epidemiol Rec. 99(19):225–248 (https://www.who.int/publications/i/item/who-wer-9919-225-248, accessed 13 May 2026).
Go back to footnote reference 6
Schmit N, Topazian HM, Natama HM, Bellamy D, Traoré O et al. The public health impact and cost-effectiveness of the R21/Matrix-M malaria vaccine: a mathematical modelling study. Lancet Infect Dis. 2024;24(5):465–475. doi:10.1016/S1473-3099(23)00816-2.
Go back to footnote reference 7
World Health Organization (2024). Malaria vaccines: WHO position paper, May 2024. Wkly Epidemiol Rec. 99(19):225–248 (https://www.who.int/publications/i/item/who-wer-9919-225-248, accessed 13 May 2026).