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Cost-effectiveness of Haemophilus influenzae type b vaccine in Vietnam.
Vaccine. 2015 Aug 26; 33(36):4639-46.V

Abstract

BACKGROUND

With GAVI support, Vietnam introduced Haemophilus influenzae type b (Hib) vaccine in 2010 without evidence on cost-effectiveness. We aimed to analyze the cost-effectiveness of Hib vaccine from societal and governmental perspectives.

METHOD

We constructed a decision-tree cohort model to estimate the costs and effectiveness of Hib vaccine versus no Hib vaccine for the 2011 birth cohort. The disease burden was estimated from local epidemiologic data and literature. Vaccine delivery costs were calculated from governmental reports and 2013 vaccine prices. A prospective cost-of-illness study was conducted to estimate treatment costs. The human capital approach was employed to estimate productivity loss. The incremental costs of Hib vaccine were divided by cases, deaths, and disability-adjusted life years (DALY) averted. We used the WHO recommended cost-effectiveness thresholds of an intervention being highly cost-effective if incremental costs per DALY were below GDP per capita.

RESULT

From the societal perspective, incremental costs per discounted case, death and DALY averted were US$ 6252, US$ 26,476 and US$ 1231, respectively; the break-even vaccine price was US$ 0.69/dose. From the governmental perspective, the results were US$ 6954, US$ 29,449, and US$ 1373, respectively; the break-even vaccine price was US$ 0.48/dose. Vietnam's GDP per capita was US$ 1911 in 2013. In deterministic sensitivity analysis, morbidity and mortality parameters were among the most influential factors. In probabilistic sensitivity analysis, Hib vaccine had an 84% and 78% probability to be highly cost-effective from the societal and governmental perspectives, respectively.

CONCLUSION

Hib vaccine was highly cost-effective from both societal and governmental perspectives. However, with GAVI support ending in 2016, the government will face a six-fold increase in its vaccine budget at the 2013 vaccine price. The variability of vaccine market prices adds an element of uncertainty. Increased government commitment and improved resource allocation decision making will be necessary to retain Hib vaccine.

Authors+Show Affiliations

University of Texas School of Public Health, United States. Electronic address: phuc.h.le@uth.tmc.edu.London School of Hygiene and Tropical Medicine, United Kingdom.Vietnam National Institute of Hygiene and Epidemiology, Viet Nam.University of Texas School of Public Health, United States.University of Texas School of Public Health, United States.University of Texas School of Public Health, United States.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26044493

Citation

Le, Phuc, et al. "Cost-effectiveness of Haemophilus Influenzae Type B Vaccine in Vietnam." Vaccine, vol. 33, no. 36, 2015, pp. 4639-46.
Le P, Griffiths UK, Anh DD, et al. Cost-effectiveness of Haemophilus influenzae type b vaccine in Vietnam. Vaccine. 2015;33(36):4639-46.
Le, P., Griffiths, U. K., Anh, D. D., Franzini, L., Chan, W., & Swint, J. M. (2015). Cost-effectiveness of Haemophilus influenzae type b vaccine in Vietnam. Vaccine, 33(36), 4639-46. https://doi.org/10.1016/j.vaccine.2015.05.050
Le P, et al. Cost-effectiveness of Haemophilus Influenzae Type B Vaccine in Vietnam. Vaccine. 2015 Aug 26;33(36):4639-46. PubMed PMID: 26044493.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of Haemophilus influenzae type b vaccine in Vietnam. AU - Le,Phuc, AU - Griffiths,Ulla K, AU - Anh,Dang Duc, AU - Franzini,Luisa, AU - Chan,Wenyaw, AU - Swint,J Michael, Y1 - 2015/06/01/ PY - 2015/03/16/received PY - 2015/05/14/revised PY - 2015/05/20/accepted PY - 2015/6/6/entrez PY - 2015/6/6/pubmed PY - 2016/5/19/medline KW - Cost-effectiveness KW - Haemophilus influenzae type b KW - Vietnam SP - 4639 EP - 46 JF - Vaccine JO - Vaccine VL - 33 IS - 36 N2 - BACKGROUND: With GAVI support, Vietnam introduced Haemophilus influenzae type b (Hib) vaccine in 2010 without evidence on cost-effectiveness. We aimed to analyze the cost-effectiveness of Hib vaccine from societal and governmental perspectives. METHOD: We constructed a decision-tree cohort model to estimate the costs and effectiveness of Hib vaccine versus no Hib vaccine for the 2011 birth cohort. The disease burden was estimated from local epidemiologic data and literature. Vaccine delivery costs were calculated from governmental reports and 2013 vaccine prices. A prospective cost-of-illness study was conducted to estimate treatment costs. The human capital approach was employed to estimate productivity loss. The incremental costs of Hib vaccine were divided by cases, deaths, and disability-adjusted life years (DALY) averted. We used the WHO recommended cost-effectiveness thresholds of an intervention being highly cost-effective if incremental costs per DALY were below GDP per capita. RESULT: From the societal perspective, incremental costs per discounted case, death and DALY averted were US$ 6252, US$ 26,476 and US$ 1231, respectively; the break-even vaccine price was US$ 0.69/dose. From the governmental perspective, the results were US$ 6954, US$ 29,449, and US$ 1373, respectively; the break-even vaccine price was US$ 0.48/dose. Vietnam's GDP per capita was US$ 1911 in 2013. In deterministic sensitivity analysis, morbidity and mortality parameters were among the most influential factors. In probabilistic sensitivity analysis, Hib vaccine had an 84% and 78% probability to be highly cost-effective from the societal and governmental perspectives, respectively. CONCLUSION: Hib vaccine was highly cost-effective from both societal and governmental perspectives. However, with GAVI support ending in 2016, the government will face a six-fold increase in its vaccine budget at the 2013 vaccine price. The variability of vaccine market prices adds an element of uncertainty. Increased government commitment and improved resource allocation decision making will be necessary to retain Hib vaccine. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/26044493/Cost_effectiveness_of_Haemophilus_influenzae_type_b_vaccine_in_Vietnam_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(15)00713-6 DB - PRIME DP - Unbound Medicine ER -