Journal article
The global impact and cost-effectiveness of a melioidosis vaccine
- Abstract:
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Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines.
Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine.
Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory.
Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 1.3MB, Terms of use)
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- Publisher copy:
- 10.1186/s12916-019-1358-x
Authors
- Publisher:
- Springer
- Journal:
- BMC Medicine More from this journal
- Volume:
- 17
- Article number:
- 129
- Publication date:
- 2019-07-05
- Acceptance date:
- 2019-06-04
- DOI:
- EISSN:
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1741-7015
- Language:
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English
- Keywords:
- Pubs id:
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pubs:1028311
- UUID:
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uuid:a822c995-5179-4208-a309-24e5d07e2580
- Local pid:
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pubs:1028311
- Source identifiers:
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1028311
- Deposit date:
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2019-07-07
Terms of use
- Copyright holder:
- Luangasanatip et al
- Copyright date:
- 2019
- Notes:
- © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Licence:
- CC Attribution (CC BY)
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