Application of a cost-effectiveness analysis of pathogen-specific vaccines against gastroenteritis to a military population in a developing country setting |
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| Affiliation: | 1. Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St. Rm. W5519, Baltimore, MD 25101, United States;2. Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799, United States;3. Department of Internal Medicine, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23518, United States;4. Tropical and Infectious Disease Area, Transmissible Diseases Services, Peruvian Navy Medical Center, Alerta DISAMAR System, Peruvian Navy Health Directorate, Cuadra 36 S/N Avenida Venezuela, Bellavista, Callao, Peru;5. Centre for Health Economics, University of York, Heslington, York YO10 5DD, United Kingdom;1. Public Health Branch, Israel Defense Forces Medical Corps, Israel;2. Bar Ilan University, Faculty of Social Sciences, Department of Management, Israel;3. Israel Veterinary Services, Ministry of Agriculture and Rural Development, Israel;4. Clinical Virology Unit, Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel;5. Lautenberg Center for General and Tumor Immunology, The Hebrew University Faculty of Medicine, Jerusalem, Israel;6. Myers-JDC-Brookdale Institute, Jerusalem, Israel;7. Institute for Research in Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Israel;1. Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH 43205, USA;2. The Ohio State University College of Medicine, Columbus, OH 43210, USA;1. Col Health, HQ 3 Corps (Med), C/O 99 APO, India;2. Col Health, HQ Southern Command, Pune 411040, India;1. IQVIA, Corporate Village, Davos Building, Da Vincilaan 7, 1930 Zaventem, Belgium;2. Department of Psychiatry, University Hospital of Saint-Etienne, TAPE Laboratory, EA7423, Jean Monnet University, 42100 Saint-Étienne, France;3. Janssen-Cilag, Rue Camille Desmoulins 1, TSA 91003, 92787 Issy-les-Moulineaux, France |
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| Abstract: | Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and norovirus-associated gastroenteritis. We compared implementation costs with current medical management in the Peruvian armed forces, a special population of low- and middle-income (LMIC) adults with a high incidence of infectious gastroenteritis. Pathogen-specific vaccine implementation resulted in calculated cost-effectiveness ratio (CER) per duty day lost averted (CERDDL) of $13,741; $1,272; $301; and $803, and a CER per diarrhea day averted of $2,130; $215; $51; and $199 for Campylobacter, ETEC, Shigella, and norovirus, respectively. These estimates compare favorably to CERDDL estimates from high-income military population and suggest that implementing vaccines gastroenteritis may be cost-effective in the Peruvian military population. |
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| Keywords: | Gastroenteritis Vaccine Cost-effectiveness analysis Low- and middle-income countries Military Peru |
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