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The potential economic value of a Trypanosoma cruzi (chagas disease) vaccine in Latin America

Lee, BY and Bacon, KM and Connor, DL and Willig, AM and Bailey, RR (2010) The potential economic value of a Trypanosoma cruzi (chagas disease) vaccine in Latin America. PLoS Neglected Tropical Diseases, 4 (12). 1 - 8.

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Abstract

Background:Chagas disease, caused by the parasite Trypanosoma cruzi (T. cruzi), is the leading etiology of non-ischemic heart disease worldwide, with Latin America bearing the majority of the burden. This substantial burden and the limitations of current interventions have motivated efforts to develop a vaccine against T. cruzi. Methodology/Principal Findings: We constructed a decision analytic Markov computer simulation model to assess the potential economic value of a T. cruzi vaccine in Latin America from the societal perspective. Each simulation run calculated the incremental cost-effectiveness ratio (ICER), or the cost per disability-adjusted life year (DALY) avoided, of vaccination. Sensitivity analyses evaluated the impact of varying key model parameters such as vaccine cost (range: $0.50-$200), vaccine efficacy (range: 25%-75%), the cost of acutephase drug treatment (range: $10-$150 to account for variations in acutephase treatment regimens), and risk of infection (range: 1%-20%). Additional analyses determined the incremental cost of vaccinating an individual and the cost per averted congestive heart failure case. Vaccination was considered highly cost-effective when the ICER was ≤1 times the GDP/capita, still cost-effective when the ICER was between 1 and 3 times the GDP/capita, and not cost-effective when the ICER was.>3 times the GDP/capita. Our results showed vaccination to be very cost-effective and often economically dominant (i.e., saving costs as well providing health benefits) for a wide range of scenarios, e.g., even when risk of infection was as low as 1% and vaccine efficacy was as low as 25%. Vaccinating an individual could likely provide net cost savings that rise substantially as risk of infection or vaccine efficacy increase. Conclusions/Significance:Results indicate that a T. cruzi vaccine could provide substantial economic benefit, depending on the cost of the vaccine, and support continued efforts to develop a human vaccine. © 2010 Lee et al.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Lee, BYbyl1@pitt.eduBYL1
Bacon, KM
Connor, DL
Willig, AM
Bailey, RR
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
EditorGalvani, Alison PUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Date: 1 December 2010
Date Type: Publication
Journal or Publication Title: PLoS Neglected Tropical Diseases
Volume: 4
Number: 12
Page Range: 1 - 8
DOI or Unique Handle: 10.1371/journal.pntd.0000916
Schools and Programs: Graduate School of Public Health > Epidemiology
School of Medicine > Biomedical Informatics
Refereed: Yes
MeSH Headings: Adolescent; Adult; Aged; Aged, 80 and over; Chagas Disease--economics; Chagas Disease--epidemiology; Chagas Disease--prevention & control; Child; Child, Preschool; Cost-Benefit Analysis; Female; Humans; Infant; Infant, Newborn; Latin America--epidemiology; Middle Aged; Models, Statistical; Protozoan Vaccines--economics; Protozoan Vaccines--immunology; Trypanosoma cruzi--immunology; Young Adult
Other ID: NLM PMC3001903
PubMed Central ID: PMC3001903
PubMed ID: 21179503
Date Deposited: 25 Aug 2012 16:42
Last Modified: 02 Feb 2019 14:55
URI: http://d-scholarship.pitt.edu/id/eprint/13666

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