ECONOMIC EVALUATION OF DENGUE VACCINATION IN BANGKOK METROPOLITAN ADMINISTRATION
Author(s)
Liulak W1, Chuenkitmongkol S2, Thongsri W2, Beucher S3, Baurin N4, Thisyakorn U5
1Health Department ,Bangkok Metropolitan Administration, Bangkok, Thailand, 2Sanofi Pasteur, Bangkok, Thailand, 3Sanofi Pasteur, Singapore, Singapore, 4Sanofi Pasteur, Lyon, France, 5Department of Pediatrics, Faculty of Medicine,Chulalongkorn University, Bangkok, Thailand
Objectives:Dengue is a major public healthcare concern in Bangkok Metropolitan Administration (BMA), and 2015 saw the highest number of cases in the past decade. The first dengue vaccine has recently been licensed in several endemic countries. This study aims to estimate the public health impact of dengue vaccination strategies in BMA and determine cost-effective vaccination price thresholds. Methods: A dengue transmission model, specifically calibrated using Thai and Bangkok epidemiological and economic data, as well as vaccine efficacy data from two international, phase III trials, has been used to evaluate the potential public health and economic impact of dengue vaccination, over a 10 years period from public payer and societal perspectives. Five vaccination strategies were simulated including routine vaccination at 9 years old plus 1,2,3,6 and 20 catch-up cohorts, i.e.one time vaccination expansion program of all ages 10, 10-11, 10-12, 10-15 and 10-29, respectively. Threshold analysis defined upper vaccination costs based on Thai guidelines (160,000 THB per DALYs averted). 3% discount rate was applied and probabilistic sensitivity analyses were performed to assess parameters uncertainty. Results: Dengue vaccination is cost effective up to a range price of 30.36-62.66 USD per dose for all scenarios, based on a 90% coverage rate, from societal perspective. Routine at 9 plus 20 catch ups showed the highest health impact over 10 years, with ~354k prevented dengue cases, 342 prevented dengue-related deaths and 14,778 prevented DALYs. In economics aspect, this program would reduce costs to the payer and society by up to USD96 million and USD155 million, respectively. Conclusion: The analysis demonstrated that dengue vaccination is a good “value-for-money” investment and has potential to reduce dengue disease and economic burden in Bangkok. The results of this study are important for providing evidence to policy makers to decide on dengue vaccination implementation in BMA.
Conference/Value in Health Info
2016-09, ISPOR Asia Pacific 2016, Singapore
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PIN16
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Infectious Disease (non-vaccine)