Willingness to pay for oral cholera vaccines in urban Bangladesh

Sarker, Abdur Razzaque and Islam, Ziaul and Sultana, Marufa and Sheikh, Nurnabi and Mahumud, Rashidul Alam and Islam, Md. Taufiqul and Van Der Meer, Robert and Morton, Alec and Khan, Ashraful Islam and Clemens, John David and Qadri, Firdausi and Khan, Jahangir A. M. (2020) Willingness to pay for oral cholera vaccines in urban Bangladesh. PLOS One, 15 (4). e0232600. ISSN 1932-6203 (https://doi.org/10.1371/journal.pone.0232600)

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Introduction: Cholera is a highly infectious disease and remains a serious public health burden in Bangladesh. The objective of the study was to measure the private demand for oral cholera vaccines (OCV) in Bangladesh and to investigate the key determinants of this demand, reflected in the household’s willingness to pay (WTP) for oral cholera vaccine. Methods: A contingent valuation method was employed in an urban setting of Bangladesh during December 2015 to January 2016. All respondents (N= 1051) received a description of World Health Organization (WHO) prequalified OCV, Shanchol™. Interviews were conducted with either the head of households or their spouse or a major economic contributor of the households. Respondents were asked about how much at maximum they were willing to pay for OCV for their own and their household members’ protection. Results are presented as the average and median of the reported maximum WTP of the respondents with standard deviations and 95% confidence interval. Natural log-linear regression model was employed to examine the factors influencing participants’ WTP for OCV. Results: About 99% of the respondents expressed WTP for OCV with a maximum mean and median WTP per vaccination (2 doses) of US$ 2.23 and US$ 1.92 respectively. On the household level with an average number of 4.62 members, the estimated mean WTP was US$ 10 (median: US$ 7.69) which represents the perceived demand for OCV of a household to vaccinate against cholera. Conclusions: The demand of vaccination further indicates that there is a potential scope for recovering a certain portion of the expenditure of immunization program by introducing direct user fees for future cholera vaccination in Bangladesh. Findings from this study will be useful for the policy-makers to make decision on cost-recovery in future oral cholera vaccination programs in Bangladesh and in similar countries.