Dengue Dynamics and Vaccine Cost-Effectiveness Analysis in the Philippines.
Dengue is one of the most problematic vector-borne diseases in the Philippines, with an estimated 842,867 cases resulting in medical costs of $345 million U.S. dollars annually. In December 2015, the first dengue vaccine, known as chimeric yellow fever virus-dengue virus tetravalent dengue vaccine, was approved for use in the Philippines and is given to children 9 years of age. To estimate the cost-effectiveness of dengue vaccination in the Philippines, we developed an age-structured model of dengue transmission and vaccination. Using our model, we compared two vaccination scenarios entailing routine vaccination programs both with and without catch-up vaccination. Our results indicate that the higher the cost of vaccination, the less cost-effective the dengue vaccination program. With the current dengue vaccination program that vaccinates children 9 years of age, dengue vaccination is cost-effective for vaccination costs up to $70 from a health-care perspective and up to $75 from a societal perspective. Under a favorable scenario consisting of 1 year of catch-up vaccinations that target children 9-15 years of age, followed by regular vaccination of 9-year-old children, vaccination is cost-effective at costs up to $72 from a health-care perspective and up to $78 from a societal perspective. In general, dengue vaccination is expected to reduce the incidence of both dengue fever and dengue hemorrhagic fever /dengue shock syndrome. Our results demonstrate that even at relatively low vaccine efficacies, age-targeted vaccination may still be cost-effective provided the vaccination cost is sufficiently low.
Department of Mathematics, Soongsil University, Seoul, Republic of Korea.
Eunha
E
Shim
D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D003715:Dengue / Q000453:epidemiology* / Q000517:prevention & control; D053059:Dengue Vaccines / Q000008:administration & dosage / Q000191:economics*; D003716:Dengue Virus; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D018803:Models, Economic; D010679:Philippines / Q000453:epidemiology; D019595:Severe Dengue / Q000453:epidemiology* / Q000517:prevention & control; D014611:Vaccination / Q000191:economics; D015005:Yellow fever virus
D053059:Dengue Vaccines