[The cost-effectiveness of Haemophilus influenzae type b vaccine for children under 2 years of age in Colombia].
OBJECTIVE
Conjugate vaccines are the best public health tools available for preventing most invasive diseases caused by Haemophilus influenzae type b (Hib), but the high cost of the vaccines has so far kept them from being introduced worldwide. The objective of this study was to estimate the cost-effectiveness of introducing Hib conjugate vaccines for the prevention of meningitis and pneumonia among children under 2 years of age in Colombia.


METHODS
We estimated the direct and indirect costs of managing in-hospital pneumonia and meningitis cases. In addition, following the recommendations of the World Health Organization, we assessed the cost-effectiveness of Hib vaccination programs. We also estimated the costs for preventing Hib cases, and the cost per year of life saved in two hypothetical situations: (1) with vaccination against Hib (with 90% coverage) and (2) without vaccination.


RESULTS
The average in-hospital treatment costs were 611.50 US$ (95% confidence interval (95% CI) = 532.2 to 690.8 US$) per case of pneumonia and 848.9 US$ (95% CI = 716.8 to 981.0 US$) per case of meningitis. The average cost per Hib case prevented was 316.7 US$ (95% CI = 294.2 to 339.2 US$). In terms of cost-effectiveness, the cost would be 2.38 US$ per year of life saved for vaccination, versus 3.81 US$ per year of life saved without vaccination.


CONCLUSIONS
Having an adequate Hib vaccination program in Colombia could prevent around 25,000 cases of invasive disease per year, representing a cost savings of at least 15 million US$ annually. Furthermore, the program could prevent some 700 deaths per year and save 44,054 years of life per year.
Alvis Guzmán
Nelson
N
Departamento de Investigaciones Económicas y Sociales (DIES), Facultad de Ciencias Económicas, Universidad de Cartagena, Colombia. nalvis@yahoo.com
De La Hoz Restrepo
Fernando
F
Vivas Consuelo
David
D
D016667:Bacterial Capsules; D003105:Colombia; D003362:Cost-Benefit Analysis; D006192:Haemophilus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000191:economics*; D019741:Haemophilus influenzae type b; D006801:Humans; D007223:Infant; D011135:Polysaccharides, Bacterial / Q000191:economics*
D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D011135:Polysaccharides, Bacterial