OBJECTIVES:

We estimated the cost of care for children under the dengue mass vaccination program of the Philippines. Given uncertainties on the inherent risk of the population and effects of the vaccine, we used a costing methodology to estimate how much would be needed to finance the medical care of 830,000 children who are potentially at risk from severe dengue.

METHODS:

The costing used a provider perspective with the assumption that provision of medical care as a form of indemnification. Disease transition parameters were defined to account for serostatus, dengue infection, disease presentation (asymptomatic, ambulatory, hospitalized and under intensive care). Febrile illness, net of dengue was also included to account for costs in managing dengue-related symptoms. Transition probabilities were set using available data from literature and reports. Unit costs for type of care needed were also adopted from literature.

RESULTS:

Around USD 20M or PhP 1B will be needed over a five year period to provide direct medical care for dengue and other febrile illnesses. The cost estimate does not include cost of public information and counselling, surveillance and other unanticipated complications and other health needs of affected children. The costing model was sensitive to seroprevalence and attributable risk of severe disease.Estimates will also have to be adjusted as new information becomes available.

CONCLUSIONS:

Costing was difficult with the lack of basic data such as serologic prevalence of dengue in the Philippine population. Such information is critical as the model is highly sensitive to serologic prevalence and risk levels of severe disease. Taking an indemnification approach is recommended as a conservative approach can better account for uncertainties in health care demand arising from the mass vaccination. Estimates on the cost of care can help the Philippines to quickly secure resources to respond to complications arising from mass vaccination.