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. 2011 May;84(5):764-72.
doi: 10.4269/ajtmh.2011.10-0624.

Economic value of dengue vaccine in Thailand

Bruce Y Lee  1 , Diana L Connor, Sarah B Kitchen, Kristina M Bacon, Mirat Shah, Shawn T Brown, Rachel R Bailey, Yongjua Laosiritaworn, Donald S Burke, Derek A T Cummings
Affiliations

Economic value of dengue vaccine in Thailand

Bruce Y Lee et al. Am J Trop Med Hyg. 2011 May.

Abstract

With several candidate dengue vaccines under development, this is an important time to help stakeholders (e.g., policy makers, scientists, clinicians, and manufacturers) better understand the potential economic value (cost-effectiveness) of a dengue vaccine, especially while vaccine characteristics and strategies might be readily altered. We developed a decision analytic Markov simulation model to evaluate the potential health and economic value of administering a dengue vaccine to an individual (≤ 1 year of age) in Thailand from the societal perspective. Sensitivity analyses evaluated the effects of ranging various vaccine (e.g., cost, efficacy, side effect), epidemiological (dengue risk), and disease (treatment-seeking behavior) characteristics. A ≥ 50% efficacious vaccine was highly cost-effective [< 1× per capita gross domestic product (GDP) ($4,289)] up to a total vaccination cost of $60 and cost-effective [< 3× per capita GDP ($12,868)] up to a total vaccination cost of $200. When the total vaccine series was $1.50, many scenarios were cost saving.

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Figures

Figure 1.
Figure 1.
General model structure: (A) Disease Model, (B) Disease Model Subtree for paths of an individual who begins in the Susceptible Dengue Naive state. (C) Disease Model Subtree for paths of an individual after being infected with either form of symptomatic dengue; dengue fever (DF) or dengue hemorrhagic fever (DHF). *Once a “Susceptible Dengue Naive” individual gets an infection with symptomatic or asymptomatic dengue, after they recover, they can only go to the “Susceptible Dengue Exposed” state to begin new probabilities of infection. Once an individual has experienced 2 infections, they go to the “Immune” state. **Refers to mortality resulting from causes unrelated to dengue (based on Thailand-specific life expectancy and mortality tables).
Figure 2.
Figure 2.
Incremental cost-effectiveness ratio (ICER) of dengue vaccination in U.S. dollars. Strategies are highly cost-effective at and ICER of < 4,289 (dotted line) and remain cost-effective until 12,868 (dashed line), where it becomes not cost-effective. (A) Dengue risk 5%, (B) dengue risk 9%, and (C) dengue risk %15
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