[Economic impact of introducing the injectable inactivated polio vaccine in Colombia].
OBJECTIVE
Evaluate the cost-effectiveness of introducing the injectable inactivated polio vaccine (IPV) in Colombia versus the current system based on the use of the oral vaccine (OPV).


METHODS
A Markov model was designed, based on a hypothetical cohort of newborns that would receive the IPV or the OPV vaccine, with a two-year follow-up and monthly estimates of the number of cases of vaccine-associated paralytic poliomyelitis (VAPP) that would emerge. The cost was analyzed from the perspective of the insurer (costs throughout life) and society (cases of VAPP and disability-adjusted life years [DALYs] prevented).


RESULTS
From 1988 to 1998, some 22.5 million doses of OVP were administered in Colombia and nine cases of VAPP were detected, for a rate of 4.0 yen 10-7 dose. According to the model, 2 to 4 cases of VAPP could be anticipated in the following two years. The cost of treating the VAPP cases would total US$302,008, with the cost of vaccination with OPV coming to US$737,037 and with IPV, US$5,527,777. Vaccination with IPV would prevent 64 DALYs, at a cost of US$71,062 per DALY prevented; preventing one case of VAPP by substituting OPV with IPV would cost between US$1.8 and US$2.2 million.


CONCLUSIONS
Substituting OPV with IPV is not a cost-effective measure in Colombia, even if the cellular vaccine against whooping cough currently in use were replaced with an acellular vaccine combined with an IPV.
Alvis
Nelson
N
Grupo de Investigación en Economía de la Salud, Facultad de Ciencias Económicas, Universidad de Cartagena, Campus de la Piedra de Bolívar, Cartagena, Colombia. nalvis@yahoo.com
De la Hoz
Fernando
F
Narváez
Javier
J
D003105:Colombia / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007231:Infant, Newborn; D008390:Markov Chains; D011051:Poliomyelitis / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011054:Poliovirus Vaccine, Inactivated / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics*; D015397:Program Evaluation / Q000191:economics; D019057:Quality-Adjusted Life Years; D012680:Sensitivity and Specificity
D011054:Poliovirus Vaccine, Inactivated; D011055:Poliovirus Vaccine, Oral