Assessing the Value of Dengue Vaccine TAK 003: A Cost-Effectiveness Study in Malaysia

OBJECTIVES: Dengue is a viral infection that impacts individuals of all age groups and presents a significant health and societal burden in Malaysia. Based on the TIDES study involving over 20,000 children and adolescents, vaccination with the dengue vaccine TAK-003 has demonstrated favorable long-term safety and efficacy profile against symptomatic and hospitalized dengue cases. This study aims to estimate the cost-effectiveness of implementing vaccination with TAK-003 compared to no vaccination in the national immunization program in Malaysia.

METHODS: A static model with a dynamic component was developed to allow for assessment of the impact of vaccination with TAK-003 on epidemiologic, economic and quality-of-life outcomes, while capturing the effects of both direct and indirect protection. The model was calibrated to local confirmed age-specific dengue case incidence from 2014 to 2023. Routine vaccination of 7-year-olds with TAK-003 compared with no vaccination was assessed over a time horizon of 20 years.

RESULTS: Routine vaccination of 7-year-olds with TAK-003 at 85.9% coverage resulted in estimated reductions of 39% symptomatic and 43% hospitalized dengue cases compared with no vaccination. The DALYs averted totaled 64,680. The vaccination strategy was cost saving compared to no vaccination from payer (-USD205M) and societal (-USD719M) perspectives. The savings from a societal perspective included direct medical costs (-USD543M), indirect medical costs (-USD149M), productivity loss (-USD328M), and costs related to school absenteeism (-USD37M), after accounting for the cost of vaccination and its associated expenses (USD337M).

CONCLUSIONS: Implementing TAK-003 in the national immunization program in Malaysia may result in significant cost savings attributed to a reduced number of symptomatic and hospitalized cases compared to no vaccination. Attaining a high vaccination coverage and ensuring effective program implementation is critical. Combined with existing dengue control activities, incorporating vaccination may reduce the disease burden of dengue infection in the country.