The potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America.
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 vaccin...
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doaj-f2ea8439cb4a42028bc72949797fa6092020-11-24T23:57:12ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352010-12-01412e91610.1371/journal.pntd.0000916The potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America.Bruce Y LeeKristina M BaconDiana L ConnorAlyssa M WilligRachel R BaileyChagas 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.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 acute-phase drug treatment (range: $10-$150 to account for variations in acute-phase 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.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.http://europepmc.org/articles/PMC3001903?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bruce Y Lee Kristina M Bacon Diana L Connor Alyssa M Willig Rachel R Bailey |
spellingShingle |
Bruce Y Lee Kristina M Bacon Diana L Connor Alyssa M Willig Rachel R Bailey The potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America. PLoS Neglected Tropical Diseases |
author_facet |
Bruce Y Lee Kristina M Bacon Diana L Connor Alyssa M Willig Rachel R Bailey |
author_sort |
Bruce Y Lee |
title |
The potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America. |
title_short |
The potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America. |
title_full |
The potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America. |
title_fullStr |
The potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America. |
title_full_unstemmed |
The potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America. |
title_sort |
potential economic value of a trypanosoma cruzi (chagas disease) vaccine in latin america. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS Neglected Tropical Diseases |
issn |
1935-2727 1935-2735 |
publishDate |
2010-12-01 |
description |
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.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 acute-phase drug treatment (range: $10-$150 to account for variations in acute-phase 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.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. |
url |
http://europepmc.org/articles/PMC3001903?pdf=render |
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