Cost-effectiveness of next-generation vaccines: The case of pertussis |
| |
| Affiliation: | 1. Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT, USA;2. Center for Inference and Dynamics of Infectious Disease, Fred Hutchinson Cancer Research Center, Seattle, WA, USA;3. Santa Fe Institute, Santa Fe, NM, USA;4. Institute for Disease Modeling, Bellevue, WA, USA;5. New Mexico State University, Las Cruces, NM, USA;6. Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK;7. Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA;1. Center for Infectious Disease Control, National Institute of Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA Bilthoven, The Netherlands;2. Emory University, Rollins School of Public Health, Grace Crum Rollins Building, 1518 Clifton Road, Atlanta, GA 30322, USA;3. Laboratorium voor Infectieziekten, Van Swietenlaan 2, 9728 NZ Groningen, The Netherlands;4. Groene Hart Ziekenhuis, Graaf Florisweg 77-79, 2805 AH Gouda, The Netherlands;1. Department of Mathematics, Purdue University, West Lafayette, IN, USA;2. Centers for Disease Control and Prevention, Atlanta, GA, USA;4. Scientific Advice Unit, European Centre for Disease Prevention and Control, Solna, Sweden;1. Dirección Nacional de Control de Enfermedades Inmunoprevenibles (DiNaCEI), Ministerio de Salud de la Nación, Argentina;2. Fundacion INFANT, Buenos Aires, Argentina;3. Vanderbilt University, Nashville, TN, United States;4. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina;1. School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK;2. Department of Mathematics, Imperial College London, South Kensington Campus, London SW7 2AZ, UK;3. Department of Veterinary Medicine, University of Cambridge, UK;1. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England, United Kingdom;2. Immunisation, Hepatitis and Blood Safety Department, Public Health England, London, England, United Kingdom;3. Statistics and Modelling Unit, Public Health England, London, England, United Kingdom;1. Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia;2. Murdoch Childrens Research Institute, Royal Childrens Hospital, Parkville, Australia;3. School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia;4. National Centre for Immunisation Research and Surveillance, The Children''s Hospital at Westmead, Westmead, Australia |
| |
| Abstract: | Despite steady vaccination coverage rates, pertussis incidence in the United States has continued to rise. This public health challenge has motivated calls for the development of a new vaccine with greater efficacy and duration of protection. Any next-generation vaccine would likely come at a higher cost, and must provide sufficient health benefits beyond those provided by the current vaccine in order to be deemed cost-effective. Using an age-structured transmission model of pertussis, we quantified the health and economic benefits of a next-generation vaccine that would enhance either the efficacy or duration of protection of the childhood series, the duration of the adult booster, or a combination. We developed a metric, the maximum cost-effective price increase (MCPI), to compare the potential value of such improvements. The MCPI estimates the per-dose price increase that would maintain the cost-effectiveness of pertussis vaccination. We evaluated the MCPI across a range of potential single and combined improvements to the pertussis vaccine. As an upper bound, we found that a next-generation vaccine which could achieve perfect efficacy for the childhood series would permit an MCPI of $18 per dose (95% CI: $12–$31). Pertussis vaccine improvements that extend the duration of protection to an average of 75 years would allow for an MCPI of $22 per dose for the childhood series (CI: $10–$33) or $12 for the adult booster (CI: $4–$18). Despite the short duration of the adult booster, improvements to the childhood series could be more valuable than improvements to the adult booster. Combining improvements in both efficacy and duration, a childhood series with perfect efficacy and average duration of 75 years would permit an MCPI of $39 per dose, the highest of any scenario evaluated. Our results highlight the utility of the MCPI metric in evaluating potential vaccines or other interventions when prices are unknown. |
| |
| Keywords: | Cost-effectiveness Mathematical modeling Pertussis Price Vaccine |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
