title: Impact and cost-effectiveness of Haemophilus influenzae type b conjugate vaccination in India.
abstract: OBJECTIVE
  To estimate the potential health impact and cost-effectiveness of nationwide Haemophilus influenzae type b (Hib) vaccination in India.
  
  
  METHODS
  A decision support model was used, bringing together estimates of demography, epidemiology, Hib vaccine effectiveness, Hib vaccine costs, and health care costs. Scenarios favorable and unfavorable to the vaccine were evaluated. State-level analyses indicate where the vaccine might have the greatest impact and value.
  
  
  RESULTS
  Between 2012 and 2031, Hib conjugate vaccination is estimated to prevent over 200 000 child deaths (∼1% of deaths in children <5 years of age) in India at an incremental cost of US$127 million per year. From a government perspective, state-level cost-effectiveness ranged from US$192 to US$1033 per discounted disability adjusted life years averted. With the inclusion of household health care costs, cost-effectiveness ranged from US$155-US$939 per discounted disability adjusted life year averted. These values are below the World Health Organization thresholds for cost effectiveness of public health interventions.
  
  
  CONCLUSIONS
  Hib conjugate vaccination is a cost-effective intervention in all States of India. This conclusion does not alter with plausible changes in key parameters. Although investment in Hib conjugate vaccination would significantly increase the cost of the Universal Immunization Program, about 15% of the incremental cost would be offset by health care cost savings. Efforts should be made to expedite the nationwide introduction of Hib conjugate vaccination in India.
authors.affiliation: Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom. andrew.clark@lshtm.ac.uk
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Clark
authors.forename: Ulla K
authors.initials: UK
authors.lastname: Griffiths
authors.forename: Syed Shahid
authors.initials: SS
authors.lastname: Abbas
authors.forename: Krishna D
authors.initials: KD
authors.lastname: Rao
authors.forename: Lois
authors.initials: L
authors.lastname: Privor-Dumm
authors.forename: Rana
authors.initials: R
authors.lastname: Hajjeh
authors.forename: Hope
authors.initials: H
authors.lastname: Johnson
authors.forename: Colin
authors.initials: C
authors.lastname: Sanderson
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
mesh_terms: D016667:Bacterial Capsules; D002648:Child; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D006192:Haemophilus Infections / Q000191:economics* / Q000276:immunology / Q000517:prevention & control; D018073:Haemophilus Vaccines / Q000191:economics*; D019741:Haemophilus influenzae type b / Q000276:immunology*; D017048:Health Care Costs; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007194:India; D008583:Meningitis, Haemophilus / Q000191:economics* / Q000453:epidemiology / Q000276:immunology; D018074:Vaccines, Conjugate / Q000191:economics* / Q000276:immunology
chemical_list: D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D018074:Vaccines, Conjugate