Economic evaluation and budget impact analysis of dengue vaccination following pre-vaccination serological screening in India |
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| Affiliation: | 1. World Health Organization Regional Office for Europe, UN City, Marmorvej 51, 2100 Copenhagen, Denmark;2. USA Centers for Disease Control and Prevention, 1600 Clifton Rd, MS H24-2, Atlanta, GA 30329, USA;3. World Health Organization Headquarters, Avenue Appia 20, 1211 Geneva, Switzerland;1. Department of Family Medicine, University of Pittsburgh, Pittsburgh, PA, USA;2. Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA;3. Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA;4. National Center Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta GA, USA;1. Infection and Immunity, Murdoch Children’s Research Institute (MCRI), Melbourne, Australia;2. Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Australia;3. London School of Hygiene and Tropical Medicine, London, UK;4. Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, Australia;1. RTI Health Solutions, Research Triangle Park, NC, USA;2. NoviSci, Durham, NC, USA;3. Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA;4. Division of Pediatric Nephrology, Hypertension and Pheresis, Departments of Pediatrics and Nephrology, Washington University School of Medicine, St. Louis, MO, USA;5. Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;6. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA;1. Department of Infectious Diseases, Istituto Superiore di Sanità, Roma, Italy;2. Institute of Hygiene and Public Health, Catholic University-Policlinico Gemelli, Roma, Italy;1. Department of Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV 26506-9448 USA;2. Rutgers University, School of Social Work, 120 Albany Street, New Brunswick, NJ 08901 USA;3. Department of Surgery, Penn State, Cancer Institute, Hershey, PA 17033 USA;4. Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV 26506-9510 USA |
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| Abstract: | ObjectivesTo evaluate the budget impact and cost-effectiveness of dengue vaccination following pre-vaccination serological screening in India.MethodsWe used a static cohort model (combination of decision tree and Markov model) to compare dengue disease and cost burden with and without dengue vaccination program with serological screening for a hypothetical cohort of 10-year-old adolescents. Budget impact was expressed in terms of total budget required for implementation of vaccination programme. Program impact was expressed in terms of disability-adjusted life-years (DALYs) averted. Cost effectiveness was expressed as costs per DALY averted. All costs are expressed in 2018 US dollars. Sensitivity analysis was performed for ICERs in different vaccination scenarios.ResultsThe total budget for implementation of dengue vaccination programme is approximately around US$ 530 million (INR 3620 crores). Our model results suggest dengue vaccination result in a net gain of almost 86,000 DALYS. We found the Dengue vaccine to be a cost-effective intervention with an ICER of $3364 (INR 2,30,098) which is less than three-times GDP per capita of India ($6047; INR 413,601). One-way sensitivity analysis shows that the ICER is most affected by the overall incidence of dengue infections followed by vaccine price. Probabilistic sensitivity analysis shows that ICER for dengue vaccination varied from $1182 (INR 80,837) to $6367 (INR 435,439).ConclusionOur study shows that dengue vaccine with pre-vaccination serological screening programme is a cost-effective intervention with the conservative estimates. |
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| Keywords: | Cost-effectiveness analysis Dengue vaccine Health economics India Markov model |
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