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

TitleThe potential economic value of a Trypanosoma cruzi (Chagas disease) vaccine in Latin America.
Publication TypeJournal Article
Year of Publication2010
AuthorsLee BY, Bacon KM, Connor DL, Willig AM, Bailey RR
JournalPLoS Negl Trop Dis
Volume4
Issue12
Paginatione916
Date Published2010
ISSN1935-2735
KeywordsAdolescent, Adult, Aged, Aged, 80 and over, Chagas Disease, Child, Child, Preschool, Cost-Benefit Analysis, Female, Humans, Infant, Infant, Newborn, Latin America, Middle Aged, Models, Statistical, Protozoan Vaccines, Trypanosoma cruzi, Young Adult
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 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.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.

DOI10.1371/journal.pntd.0000916
Alternate JournalPLoS Negl Trop Dis
PubMed ID21179503
PubMed Central IDPMC3001903
Grant List1U54GM088491-0109 / GM / NIGMS NIH HHS / United States
U54 GM088491 / GM / NIGMS NIH HHS / United States
Publication Categories: