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Cost effectiveness of dengue vaccination following pre-vaccination serological screening in Sri Lanka

Published online by Cambridge University Press:  18 October 2019

Sathira Perera Open the ORCID record for Sathira Perera [Opens in a new window] ,
Denny John Open the ORCID record for Denny John [Opens in a new window]  and
Buddhika Senanayaka
Sathira Perera*
Affiliation:
University of New South Wales, Sydney, Australia Ministry of Health, Colombo, Sri Lanka
Denny John
Affiliation:
Campbell Collaboration, New Delhi, India National Institute of Medical Statistics (NIMS), ICMR, New Delhi, India
Buddhika Senanayaka
Affiliation:
Post Graduate Institute of Medicine, Colombo, Sri Lanka
*
Author for correspondence: Sathira Perera, E-mail: sathira.perera@student.unsw.edu.au
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Abstract

Objective

This study sets an example of an economic evaluation of a model dengue vaccination strategy for Sri Lanka, following a mandatory pre-vaccination screening strategy.

Methods

A decision analytic Markov model was developed to estimate the cost-effectiveness of a predicted dengue vaccination strategy over a time horizon of 10 years. The cost effectiveness of dengue vaccination strategy for seropositive individuals was estimated in terms of incremental cost effectiveness ratio (ICER) (cost per additional quality adjusted life-year [QALY]). District-specific ICER values and the budget impact for dengue vaccine were estimated with appropriate sensitivity analyses, also taking the variability of the pre-vaccination screening test performance into consideration.

Results

The ICER for the predicted vaccination strategy following pre-vaccination screening was 4,382 USD/QALY for Sri Lanka. There was a significant regional variation in vaccine cost effectiveness. The disaggregated regional incidence of dengue and the need to perform pre-vaccination screening affects the cost effectiveness estimates significantly, where a safer version of the vaccine has the potential to become cost saving in high incidence districts.

Conclusions

The cost effectiveness of the predicted dengue vaccination strategy following pre-vaccination screening showed a significant regional variation across the districts of Sri Lanka. District-wise disease incidence and the need for pre-vaccination screening was found to be the most significant factors affecting the cost effectiveness of the vaccine.

Keywords

Cost effectiveness analysisDengue vaccinationLower middle-income countries
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 6 , 2019 , pp. 427 - 435
Copyright
Copyright © Cambridge University Press 2019

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