The global impact and cost-effectiveness of a melioidosis vaccine
Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines...
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doaj-0d6d0d121fc44e6697f34b935c18b93d2020-11-25T02:55:14ZengBMCBMC Medicine1741-70152019-07-0117111110.1186/s12916-019-1358-xThe global impact and cost-effectiveness of a melioidosis vaccineNantasit Luangasanatip0Stefan Flasche1David A. B. Dance2Direk Limmathurotsakul3Bart J. Currie4Chiranjay Mukhopadhyay5Tim Atkins6Richard Titball7Mark Jit8Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineDepartment of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineLao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU)Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol UniversityGlobal and Tropical Health Division, Menzies School of Health ResearchDepartment of Microbiology, Kasturba Medical College, Manipal Academy of Higher EducationCollege of Life and Environmental Sciences, University of ExeterCollege of Life and Environmental Sciences, University of ExeterDepartment of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical MedicineAbstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission.http://link.springer.com/article/10.1186/s12916-019-1358-xMelioidosisInfectionsVaccineCost-effectivenessEconomic evaluation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nantasit Luangasanatip Stefan Flasche David A. B. Dance Direk Limmathurotsakul Bart J. Currie Chiranjay Mukhopadhyay Tim Atkins Richard Titball Mark Jit |
spellingShingle |
Nantasit Luangasanatip Stefan Flasche David A. B. Dance Direk Limmathurotsakul Bart J. Currie Chiranjay Mukhopadhyay Tim Atkins Richard Titball Mark Jit The global impact and cost-effectiveness of a melioidosis vaccine BMC Medicine Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation |
author_facet |
Nantasit Luangasanatip Stefan Flasche David A. B. Dance Direk Limmathurotsakul Bart J. Currie Chiranjay Mukhopadhyay Tim Atkins Richard Titball Mark Jit |
author_sort |
Nantasit Luangasanatip |
title |
The global impact and cost-effectiveness of a melioidosis vaccine |
title_short |
The global impact and cost-effectiveness of a melioidosis vaccine |
title_full |
The global impact and cost-effectiveness of a melioidosis vaccine |
title_fullStr |
The global impact and cost-effectiveness of a melioidosis vaccine |
title_full_unstemmed |
The global impact and cost-effectiveness of a melioidosis vaccine |
title_sort |
global impact and cost-effectiveness of a melioidosis vaccine |
publisher |
BMC |
series |
BMC Medicine |
issn |
1741-7015 |
publishDate |
2019-07-01 |
description |
Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission. |
topic |
Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation |
url |
http://link.springer.com/article/10.1186/s12916-019-1358-x |
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