An economic evaluation of vector control in the age of a dengue vaccine.
Dengue is a rapidly emerging vector-borne Neglected Tropical Disease, with a 30-fold increase in the number of cases reported since 1960. The economic cost of the illness is measured in the billions of dollars annually. Environmental change and unplanned urbanization are conspiring to raise the heal...
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ftdoajarticles:oai:doaj.org/article:de7417417ca94aeea2238c8b619a6e63 2023-05-15T15:15:35+02:00 An economic evaluation of vector control in the age of a dengue vaccine. Christopher Fitzpatrick Alexander Haines Mathieu Bangert Andrew Farlow Janet Hemingway Raman Velayudhan 2017-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005785 https://doaj.org/article/de7417417ca94aeea2238c8b619a6e63 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5573582?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005785 https://doaj.org/article/de7417417ca94aeea2238c8b619a6e63 PLoS Neglected Tropical Diseases, Vol 11, Iss 8, p e0005785 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005785 2022-12-31T01:39:01Z Dengue is a rapidly emerging vector-borne Neglected Tropical Disease, with a 30-fold increase in the number of cases reported since 1960. The economic cost of the illness is measured in the billions of dollars annually. Environmental change and unplanned urbanization are conspiring to raise the health and economic cost even further beyond the reach of health systems and households. The health-sector response has depended in large part on control of the Aedes aegypti and Ae. albopictus (mosquito) vectors. The cost-effectiveness of the first-ever dengue vaccine remains to be evaluated in the field. In this paper, we examine how it might affect the cost-effectiveness of sustained vector control.We employ a dynamic Markov model of the effects of vector control on dengue in both vectors and humans over a 15-year period, in six countries: Brazil, Columbia, Malaysia, Mexico, the Philippines, and Thailand. We evaluate the cost (direct medical costs and control programme costs) and cost-effectiveness of sustained vector control, outbreak response and/or medical case management, in the presence of a (hypothetical) highly targeted and low cost immunization strategy using a (non-hypothetical) medium-efficacy vaccine.Sustained vector control using existing technologies would cost little more than outbreak response, given the associated costs of medical case management. If sustained use of existing or upcoming technologies (of similar price) reduce vector populations by 70-90%, the cost per disability-adjusted life year averted is 2013 US$ 679-1331 (best estimates) relative to no intervention. Sustained vector control could be highly cost-effective even with less effective technologies (50-70% reduction in vector populations) and in the presence of a highly targeted and low cost immunization strategy using a medium-efficacy vaccine.Economic evaluation of the first-ever dengue vaccine is ongoing. However, even under very optimistic assumptions about a highly targeted and low cost immunization strategy, our results suggest that ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 8 e0005785 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Christopher Fitzpatrick Alexander Haines Mathieu Bangert Andrew Farlow Janet Hemingway Raman Velayudhan An economic evaluation of vector control in the age of a dengue vaccine. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Dengue is a rapidly emerging vector-borne Neglected Tropical Disease, with a 30-fold increase in the number of cases reported since 1960. The economic cost of the illness is measured in the billions of dollars annually. Environmental change and unplanned urbanization are conspiring to raise the health and economic cost even further beyond the reach of health systems and households. The health-sector response has depended in large part on control of the Aedes aegypti and Ae. albopictus (mosquito) vectors. The cost-effectiveness of the first-ever dengue vaccine remains to be evaluated in the field. In this paper, we examine how it might affect the cost-effectiveness of sustained vector control.We employ a dynamic Markov model of the effects of vector control on dengue in both vectors and humans over a 15-year period, in six countries: Brazil, Columbia, Malaysia, Mexico, the Philippines, and Thailand. We evaluate the cost (direct medical costs and control programme costs) and cost-effectiveness of sustained vector control, outbreak response and/or medical case management, in the presence of a (hypothetical) highly targeted and low cost immunization strategy using a (non-hypothetical) medium-efficacy vaccine.Sustained vector control using existing technologies would cost little more than outbreak response, given the associated costs of medical case management. If sustained use of existing or upcoming technologies (of similar price) reduce vector populations by 70-90%, the cost per disability-adjusted life year averted is 2013 US$ 679-1331 (best estimates) relative to no intervention. Sustained vector control could be highly cost-effective even with less effective technologies (50-70% reduction in vector populations) and in the presence of a highly targeted and low cost immunization strategy using a medium-efficacy vaccine.Economic evaluation of the first-ever dengue vaccine is ongoing. However, even under very optimistic assumptions about a highly targeted and low cost immunization strategy, our results suggest that ... |
format |
Article in Journal/Newspaper |
author |
Christopher Fitzpatrick Alexander Haines Mathieu Bangert Andrew Farlow Janet Hemingway Raman Velayudhan |
author_facet |
Christopher Fitzpatrick Alexander Haines Mathieu Bangert Andrew Farlow Janet Hemingway Raman Velayudhan |
author_sort |
Christopher Fitzpatrick |
title |
An economic evaluation of vector control in the age of a dengue vaccine. |
title_short |
An economic evaluation of vector control in the age of a dengue vaccine. |
title_full |
An economic evaluation of vector control in the age of a dengue vaccine. |
title_fullStr |
An economic evaluation of vector control in the age of a dengue vaccine. |
title_full_unstemmed |
An economic evaluation of vector control in the age of a dengue vaccine. |
title_sort |
economic evaluation of vector control in the age of a dengue vaccine. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005785 https://doaj.org/article/de7417417ca94aeea2238c8b619a6e63 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 8, p e0005785 (2017) |
op_relation |
http://europepmc.org/articles/PMC5573582?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005785 https://doaj.org/article/de7417417ca94aeea2238c8b619a6e63 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005785 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
11 |
container_issue |
8 |
container_start_page |
e0005785 |
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1766345958122061824 |