Affordability of Adult Tuberculosis Vaccination in India and China: A Dynamic Transmission Model-Based Analysis.
作者： Chathika Krishan Weerasuriya , Rebecca Claire Harris , Matthew Quaife , Christopher Finn McQuaid , Richard G White
关键词:
摘要: New tuberculosis vaccines have made substantial progress in the development pipeline. Previous modelling suggests that adolescent/adult mass vaccination may cost-effectively contribute towards achieving global control goals. These analyses not considered budgetary feasibility of vaccine programmes. We estimate maximum total cost public health sectors India and China should expect to pay introduce a M72/AS01E-like deemed cost-effective at country-specific willingness thresholds for cost-effectiveness. To disability adjusted life years (DALYs) averted by programme, we simulated 50% efficacy providing 10-years protection post-infection populations between 2027 2050 using dynamic transmission model M. tuberculosis. investigated two strategies, both delivered every 70% coverage: Vaccinating adults adolescents (age ≥10y), or only most efficient 10-year age subgroup (defined as greatest DALYs per given). used cost-effectiveness (Cmax) government be willing each strategy. Adult/adolescent resulted Cmax $21 billion (uncertainty interval [UI]: 16-27) India, $15B (UI:12-29) $264/DALY $3650/DALY averted, respectively. highest efficiency group (India: 50-59y; China: 60-69y) $5B (UI:4-6) $6B (UI:4-7) China. Mass against all adolescents, cost-effective, will likely impose burden. Targeted vaccination, represent more affordable approach.
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