A cost-benefit analysis of programmatic use of CVD 103-HgR live oral cholera vaccine in a high-risk population.

Abstract

BACKGROUND:

Cholera spread to Latin America in 1991; subsequently, cholera vaccination was considered as an interim intervention until long-term solutions involving improved water supplies and sanitation could be introduced. Three successive summer cholera outbreaks in northern Argentina and the licensing of the new single-dose oral cholera vaccine, CVD 103-HgR, raised questions of the cost and benefit of using this new vaccine.

METHODS:

This study explored the potential benefits to the Argentine Ministry of Health of treatment costs averted, versus the costs of vaccination with CVD 103-HgR in the relatively confined population of northern Argentina affected by the cholera outbreaks. Water supplies and sanitation in this area are poor but a credible infrastructure for vaccine delivery exists.

RESULTS:

In our cost-benefit model of a 3-year period (1992-1994) with an annual incidence of 2.5 case-patients per 1000 population and assumptions of vaccine efficacy of 75% and coverage of 75%, vaccination of targeted high risk groups would prevent 1265 cases.

CONCLUSION:

Assuming a cost of US$602 per treated case and of US$1.50 per dose of vaccine, the total discounted savings from use of vaccine in the targeted groups would be US$132,100. The projected savings would be altered less by vaccine coverage (range 75-90%) or efficacy (60-85%) changes than by disease incidence changes. Our analysis underestimated the true costs of cholera in Argentina because we included only medical expenditures; Indirect losses to trade and tourism had the greatest economic impact. However, vaccination with CVD 103-HgR was still cost-beneficial in the base case.

• Authors: S T Cookson, D Stamboulian, J Demonte, L Quero, C Martinez de Arquiza, A Aleman, A Lepetic, M M Levine
• Journal: International journal of epidemiology (Int J Epidemiol) Vol. 26 Issue 1 Pg. 212-9 (Feb 1997) ISSN: 0300-5771 [Print] England
• PMID: 9126522 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Cholera Vaccines
• Vaccines, Attenuated

Topics

• Adolescent
• Adult
• Argentina (epidemiology)
• Child
• Child, Preschool
• Cholera (economics, epidemiology, immunology)
• Cholera Vaccines (administration & dosage, immunology)
• Cost-Benefit Analysis
• Disease Outbreaks (economics, prevention & control)
• Female
• Humans
• Male
• Vaccination (economics)
• Vaccines, Attenuated (administration & dosage, immunology)