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Cost-effectiveness of dengue vaccination in ten endemic countries.
Vaccine. 2018 01 08; 36(3):413-420.V

Abstract

Following publication of results from two phase-3 clinical trials in 10 countries or territories, endemic countries began licensing the first dengue vaccine in 2015. Using a published mathematical model, we evaluated the cost-effectiveness of dengue vaccination in populations similar to those at the trial sites in those same Latin American and Asian countries. Our main scenarios (30-year horizon, 80% coverage) entailed 3-dose routine vaccinations costing US$20/dose beginning at age 9, potentially supplemented by catch-up programs of 4- or 8-year cohorts. We obtained illness costs per case, dengue mortality, vaccine wastage, and vaccine administration costs from the literature. We estimated that routine vaccination would reduce yearly direct and indirect illness cost per capita by 22% (from US$10.51 to US$8.17) in the Latin American countries and by 23% (from US$5.78 to US$4.44) in the Asian countries. Using a health system perspective, the incremental cost-effectiveness ratio (ICER) averaged US$4,216/disability-adjusted life year (DALY) averted in the five Latin American countries (range: US$666/DALY in Puerto Rico to US$5,865/DALY in Mexico). In the five Asian countries, the ICER averaged US$3,751/DALY (range: US$1,935/DALY in Malaysia to US$5,101/DALY in the Philippines). From a health system perspective, the vaccine proved to be highly cost effective (ICER under one times the per capita GDP) in seven countries and cost effective (ICER 1-3 times the per capita GDP) in the remaining three countries. From a societal perspective, routine vaccination proved cost-saving in three countries. Including catch-up campaigns gave similar ICERs. Thus, this vaccine could have a favorable economic value in sites similar to those in the trials.

Authors+Show Affiliations

Brandeis University, The Heller School for Social Policy and Management, MS 035, PO Box 549110, Waltham, MA 02454-9110, USA.Brandeis University, The Heller School for Social Policy and Management, MS 035, PO Box 549110, Waltham, MA 02454-9110, USA.Sanofi Pasteur, 2, Avenue Pont Pasteur, F69367 Cedex 07 Lyon, France.Sanofi Pasteur, 2, Avenue Pont Pasteur, F69367 Cedex 07 Lyon, France.Brandeis University, The Heller School for Social Policy and Management, MS 035, PO Box 549110, Waltham, MA 02454-9110, USA. Electronic address: shepard@brandeis.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29229427

Citation

Zeng, Wu, et al. "Cost-effectiveness of Dengue Vaccination in Ten Endemic Countries." Vaccine, vol. 36, no. 3, 2018, pp. 413-420.
Zeng W, Halasa-Rappel YA, Baurin N, et al. Cost-effectiveness of dengue vaccination in ten endemic countries. Vaccine. 2018;36(3):413-420.
Zeng, W., Halasa-Rappel, Y. A., Baurin, N., Coudeville, L., & Shepard, D. S. (2018). Cost-effectiveness of dengue vaccination in ten endemic countries. Vaccine, 36(3), 413-420. https://doi.org/10.1016/j.vaccine.2017.11.064
Zeng W, et al. Cost-effectiveness of Dengue Vaccination in Ten Endemic Countries. Vaccine. 2018 01 8;36(3):413-420. PubMed PMID: 29229427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of dengue vaccination in ten endemic countries. AU - Zeng,Wu, AU - Halasa-Rappel,Yara A, AU - Baurin,Nicolas, AU - Coudeville,Laurent, AU - Shepard,Donald S, Y1 - 2017/12/08/ PY - 2017/08/15/received PY - 2017/11/14/revised PY - 2017/11/19/accepted PY - 2017/12/13/pubmed PY - 2018/7/18/medline PY - 2017/12/13/entrez SP - 413 EP - 420 JF - Vaccine JO - Vaccine VL - 36 IS - 3 N2 - Following publication of results from two phase-3 clinical trials in 10 countries or territories, endemic countries began licensing the first dengue vaccine in 2015. Using a published mathematical model, we evaluated the cost-effectiveness of dengue vaccination in populations similar to those at the trial sites in those same Latin American and Asian countries. Our main scenarios (30-year horizon, 80% coverage) entailed 3-dose routine vaccinations costing US$20/dose beginning at age 9, potentially supplemented by catch-up programs of 4- or 8-year cohorts. We obtained illness costs per case, dengue mortality, vaccine wastage, and vaccine administration costs from the literature. We estimated that routine vaccination would reduce yearly direct and indirect illness cost per capita by 22% (from US$10.51 to US$8.17) in the Latin American countries and by 23% (from US$5.78 to US$4.44) in the Asian countries. Using a health system perspective, the incremental cost-effectiveness ratio (ICER) averaged US$4,216/disability-adjusted life year (DALY) averted in the five Latin American countries (range: US$666/DALY in Puerto Rico to US$5,865/DALY in Mexico). In the five Asian countries, the ICER averaged US$3,751/DALY (range: US$1,935/DALY in Malaysia to US$5,101/DALY in the Philippines). From a health system perspective, the vaccine proved to be highly cost effective (ICER under one times the per capita GDP) in seven countries and cost effective (ICER 1-3 times the per capita GDP) in the remaining three countries. From a societal perspective, routine vaccination proved cost-saving in three countries. Including catch-up campaigns gave similar ICERs. Thus, this vaccine could have a favorable economic value in sites similar to those in the trials. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/29229427/Cost_effectiveness_of_dengue_vaccination_in_ten_endemic_countries_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(17)31663-8 DB - PRIME DP - Unbound Medicine ER -