edoc

Country specific predictions of the cost-effectiveness of malaria vaccine RTS,S/AS01 in endemic Africa

Galactionova, Katya and Tediosi, Fabrizio and Camponovo, Flavia and Smith, Thomas A. and Gething, Peter W. and Penny, Melissa A.. (2017) Country specific predictions of the cost-effectiveness of malaria vaccine RTS,S/AS01 in endemic Africa. Vaccine, 35 (1). pp. 53-60.

Full text not available from this repository.

Official URL: http://edoc.unibas.ch/53630/

Downloads: Statistics Overview

Abstract

RTS,S/AS01 is a safe and moderately efficacious vaccine considered for implementation in endemic Africa. Model predictions of impact and cost-effectiveness of this new intervention could aid in country adoption decisions.; The impact of RTS,S was assessed in 43 countries using an ensemble of models of Plasmodium falciparum epidemiology. Informed by the 32months follow-up data from the phase 3 trial, vaccine effectiveness was evaluated at country levels of malaria parasite prevalence, coverage of control interventions and immunization. Benefits and costs of the program incremental to routine malaria control were evaluated for a four dose schedule: first dose administered at six months, second and third - before 9months, and fourth dose at 27months of age. Sensitivity analyses around vaccine properties, transmission, and economic inputs were conducted.; If implemented in all 43 countries the vaccine has the potential to avert 123 (117;129) million malaria episodes over the first 10years. Burden averted averages 18,413 (range of country median estimates 156-40,054) DALYs per 100,000 fully vaccinated children with much variation across settings primarily driven by differences in transmission intensity. At a price of $5 per dose program costs average $39.8 per fully vaccinated child with a median cost-effectiveness ratio of $188 (range $78-$22,448) per DALY averted; the ratio is lower by one third - $136 (range $116-$220) - in settings where parasite prevalence in children aged 2-10years is at or above 10%.; RTS,S/AS01has the potential to substantially reduce malaria burden in children across Africa. Conditional on assumptions on price, coverage, and vaccine properties, adding RTS,S to routine malaria control interventions would be highly cost-effective. Implementation decisions will need to further consider feasibility of scaling up existing control programs, and operational constraints in reaching children at risk with the schedule.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Systems Research and Dynamic Modelling > Dynamical Modelling (Smith)
UniBasel Contributors:Tediosi, Fabrizio and Galactionova, Katya and Smith, Thomas A. and Penny, Melissa
Item Type:Article, refereed
Publisher:Elsevier
ISSN:0264-410X
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:24 Apr 2017 12:07
Deposited On:24 Apr 2017 12:07

Repository Staff Only: item control page