Application of a cost-effectiveness analysis of pathogen-specific vaccines against gastroenteritis to a military population in a developing country setting
•Vaccine cost-effectiveness modeling can inform LMIC military health policies.•Enteropathogen vaccines may be cost-effective for special LMIC adult populations.•Shigella and norovirus vaccines appear cost-effective for Peruvian troops. Vaccine implementation planning in low- and middle-income countr...
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| Veröffentlicht in: | Vaccine 2020-02, Vol.38 (10), p.2292-2297 |
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| creator | Ballard, Sarah-Blythe Tallant, Aaron Guerra, Rosio G. Quigley, Dawn Stiegmann, Regan Mirelman, Andrew J. Riddle, Mark S. Gilman, Robert H. |
| description | •Vaccine cost-effectiveness modeling can inform LMIC military health policies.•Enteropathogen vaccines may be cost-effective for special LMIC adult populations.•Shigella and norovirus vaccines appear cost-effective for Peruvian troops.
Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and norovirus-associated gastroenteritis. We compared implementation costs with current medical management in the Peruvian armed forces, a special population of low- and middle-income (LMIC) adults with a high incidence of infectious gastroenteritis. Pathogen-specific vaccine implementation resulted in calculated cost-effectiveness ratio (CER) per duty day lost averted (CERDDL) of $13,741; $1,272; $301; and $803, and a CER per diarrhea day averted of $2,130; $215; $51; and $199 for Campylobacter, ETEC, Shigella, and norovirus, respectively. These estimates compare favorably to CERDDL estimates from high-income military population and suggest that implementing vaccines gastroenteritis may be cost-effective in the Peruvian military population. |
| doi_str_mv | 10.1016/j.vaccine.2020.01.075 |
| format | Article |
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Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and norovirus-associated gastroenteritis. We compared implementation costs with current medical management in the Peruvian armed forces, a special population of low- and middle-income (LMIC) adults with a high incidence of infectious gastroenteritis. Pathogen-specific vaccine implementation resulted in calculated cost-effectiveness ratio (CER) per duty day lost averted (CERDDL) of $13,741; $1,272; $301; and $803, and a CER per diarrhea day averted of $2,130; $215; $51; and $199 for Campylobacter, ETEC, Shigella, and norovirus, respectively. These estimates compare favorably to CERDDL estimates from high-income military population and suggest that implementing vaccines gastroenteritis may be cost-effective in the Peruvian military population.</description><identifier>ISSN: 0264-410X</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2020.01.075</identifier><identifier>PMID: 32019702</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Aerospace medicine ; Armed forces ; Campylobacter ; Cost analysis ; Cost estimates ; Cost-Benefit Analysis ; Cost-effectiveness analysis ; Developing Countries ; Diarrhea ; Disease ; Economic analysis ; Economic models ; Gastroenteritis ; Gastroenteritis - economics ; Gastroenteritis - prevention & control ; Humans ; Income ; LDCs ; Low income groups ; Low- and middle-income countries ; Military ; Military Personnel ; Models, Economic ; Pathogens ; Peru ; Population ; Sensitivity analysis ; Shigella ; Surveillance ; Vaccine ; Vaccines ; Vaccines - economics ; Working groups</subject><ispartof>Vaccine, 2020-02, Vol.38 (10), p.2292-2297</ispartof><rights>2020</rights><rights>Published by Elsevier Ltd.</rights><rights>Copyright Elsevier Limited Feb 28, 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-7be399d30e74c5c644b371e03e0f432a92c2436ffd5ec4083f68b9e1d38dfdf43</citedby><cites>FETCH-LOGICAL-c495t-7be399d30e74c5c644b371e03e0f432a92c2436ffd5ec4083f68b9e1d38dfdf43</cites><orcidid>0000-0003-3581-5771</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0264410X20301171$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32019702$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ballard, Sarah-Blythe</creatorcontrib><creatorcontrib>Tallant, Aaron</creatorcontrib><creatorcontrib>Guerra, Rosio G.</creatorcontrib><creatorcontrib>Quigley, Dawn</creatorcontrib><creatorcontrib>Stiegmann, Regan</creatorcontrib><creatorcontrib>Mirelman, Andrew J.</creatorcontrib><creatorcontrib>Riddle, Mark S.</creatorcontrib><creatorcontrib>Gilman, Robert H.</creatorcontrib><creatorcontrib>Norovirus Working Group in Peru</creatorcontrib><title>Application of a cost-effectiveness analysis of pathogen-specific vaccines against gastroenteritis to a military population in a developing country setting</title><title>Vaccine</title><addtitle>Vaccine</addtitle><description>•Vaccine cost-effectiveness modeling can inform LMIC military health policies.•Enteropathogen vaccines may be cost-effective for special LMIC adult populations.•Shigella and norovirus vaccines appear cost-effective for Peruvian troops.
Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and norovirus-associated gastroenteritis. We compared implementation costs with current medical management in the Peruvian armed forces, a special population of low- and middle-income (LMIC) adults with a high incidence of infectious gastroenteritis. Pathogen-specific vaccine implementation resulted in calculated cost-effectiveness ratio (CER) per duty day lost averted (CERDDL) of $13,741; $1,272; $301; and $803, and a CER per diarrhea day averted of $2,130; $215; $51; and $199 for Campylobacter, ETEC, Shigella, and norovirus, respectively. These estimates compare favorably to CERDDL estimates from high-income military population and suggest that implementing vaccines gastroenteritis may be cost-effective in the Peruvian military population.</description><subject>Adult</subject><subject>Aerospace medicine</subject><subject>Armed forces</subject><subject>Campylobacter</subject><subject>Cost analysis</subject><subject>Cost estimates</subject><subject>Cost-Benefit Analysis</subject><subject>Cost-effectiveness analysis</subject><subject>Developing Countries</subject><subject>Diarrhea</subject><subject>Disease</subject><subject>Economic analysis</subject><subject>Economic models</subject><subject>Gastroenteritis</subject><subject>Gastroenteritis - economics</subject><subject>Gastroenteritis - prevention & control</subject><subject>Humans</subject><subject>Income</subject><subject>LDCs</subject><subject>Low income groups</subject><subject>Low- and middle-income countries</subject><subject>Military</subject><subject>Military Personnel</subject><subject>Models, Economic</subject><subject>Pathogens</subject><subject>Peru</subject><subject>Population</subject><subject>Sensitivity analysis</subject><subject>Shigella</subject><subject>Surveillance</subject><subject>Vaccine</subject><subject>Vaccines</subject><subject>Vaccines - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Vaccine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ballard, Sarah-Blythe</au><au>Tallant, Aaron</au><au>Guerra, Rosio G.</au><au>Quigley, Dawn</au><au>Stiegmann, Regan</au><au>Mirelman, Andrew J.</au><au>Riddle, Mark S.</au><au>Gilman, Robert H.</au><aucorp>Norovirus Working Group in Peru</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Application of a cost-effectiveness analysis of pathogen-specific vaccines against gastroenteritis to a military population in a developing country setting</atitle><jtitle>Vaccine</jtitle><addtitle>Vaccine</addtitle><date>2020-02-28</date><risdate>2020</risdate><volume>38</volume><issue>10</issue><spage>2292</spage><epage>2297</epage><pages>2292-2297</pages><issn>0264-410X</issn><eissn>1873-2518</eissn><abstract>•Vaccine cost-effectiveness modeling can inform LMIC military health policies.•Enteropathogen vaccines may be cost-effective for special LMIC adult populations.•Shigella and norovirus vaccines appear cost-effective for Peruvian troops.
Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and norovirus-associated gastroenteritis. We compared implementation costs with current medical management in the Peruvian armed forces, a special population of low- and middle-income (LMIC) adults with a high incidence of infectious gastroenteritis. Pathogen-specific vaccine implementation resulted in calculated cost-effectiveness ratio (CER) per duty day lost averted (CERDDL) of $13,741; $1,272; $301; and $803, and a CER per diarrhea day averted of $2,130; $215; $51; and $199 for Campylobacter, ETEC, Shigella, and norovirus, respectively. These estimates compare favorably to CERDDL estimates from high-income military population and suggest that implementing vaccines gastroenteritis may be cost-effective in the Peruvian military population.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32019702</pmid><doi>10.1016/j.vaccine.2020.01.075</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-3581-5771</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aerospace medicine Armed forces Campylobacter Cost analysis Cost estimates Cost-Benefit Analysis Cost-effectiveness analysis Developing Countries Diarrhea Disease Economic analysis Economic models Gastroenteritis Gastroenteritis - economics Gastroenteritis - prevention & control Humans Income LDCs Low income groups Low- and middle-income countries Military Military Personnel Models, Economic Pathogens Peru Population Sensitivity analysis Shigella Surveillance Vaccine Vaccines Vaccines - economics Working groups |
| title | Application of a cost-effectiveness analysis of pathogen-specific vaccines against gastroenteritis to a military population in a developing country setting |
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