OBJECTIVES:  Measles continues to cause considerable morbidity and mortality worldwide.  Presently, the conventional measles vaccine is administered in developing countries through a combination of routine immunization (RI) at nine months plus a second opportunity (SO)--either another routine injection after one year of age or via a large scale campaign.  These have proven successful in eliminating measles in the Americas; however, measles continues to prove intractable in much of Asia and Africa.  In recent years, several new, potential measles vaccine technologies are in R&D with the aim to further reduce measles cost and disease burden compared to the conventional approach alone.  Examples of such technologies include needle-free devices, DNA-based vaccines, and/or thermostable vaccines.  This economic evaluation assesses the potential cost-effectiveness of these innovations to help prioritize additional investments in their development. METHODS:  Taking a societal perspective, we developed an economic model to project the impact of innovations on costs and disability-adjusted life years averted over the period 2010 to 2050 in Cambodia and in the state of  Bihar in India. The incremental costs of at the alternative innovations were projected based on their projected impacts on elements of the marginal cost of measles administration and distribution through the cold chain.  To project vaccination coverage, measles cases, and deaths, we constructed an age-structured compartmental dynamic model of measles, parameterized with available population-specific demographic, clinical, incidence and seroprevalence data. The model was used to assess scenarios of 1) RI alone; 2) RI with SO; and 3) RI with the new technologies, and (4) RI and SO with new technologies.  RESULTS:  The new measles vaccine technologies further reduced the cost and burden of disease in the two settings, by reducing cold chain and syringe disposal costs, by expanding coverage and/or by improving effectiveness, especially at ages less than nine months.  Achieving herd immunity was shown to have a significant economic impact, with the result that some innovations might lessen the potential benefits of others.  SO programs are essential to achieve herd immunity, and their effectiveness is enhanced with some of the new technologies.CONCLUSIONS:  Innovations in measles vaccination that are currently in R&D could significantly reduce the costs and the disease burden of measles in these two Asian settings.  However, the ultimate cost-effectiveness of these new approaches versus current practice, including the likelihood of ultimate uptake, remains to be determined.