TY - JOUR
T1 - The potential economic value of a cutaneous leishmaniasis vaccine in seven endemic countries in the Americas
AU - Bacon, Kristina M.
AU - Hotez, Peter J.
AU - Kruchten, Stephanie D.
AU - Kamhawi, Shaden
AU - Bottazzi, Maria Elena
AU - Valenzuela, Jesus G.
AU - Lee, Bruce Y.
N1 - Funding Information:
Funding: Supported by the Vaccine Modeling Initiative (VMI) , funded by the Bill and Melinda Gates Foundation and the National Institute of General Medical Sciences Models of Infectious Disease Agent Study (MIDAS) through grant 5U54GM088491-02 . Funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.
PY - 2013/1/7
Y1 - 2013/1/7
N2 - Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Markov decision analytic computer model to evaluate the potential economic value of a preventative CL vaccine in seven countries in Latin America: Bolivia, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela. The results indicated that even a vaccine with a relatively short duration of protection and modest efficacy could be recommended for use in targeted locations, as it could prevent a substantial number of cases at low-cost and potentially even result in cost savings. If the population in the seven countries were vaccinated using a vaccine that provides at least 10 years of protection, an estimated 41,000-144,784 CL cases could be averted, each at a cost less than the cost of current recommended treatments. Further, even a vaccine providing as little as five years duration of protection with as little as 50% efficacy remains cost-effective compared with chemotherapy; additional scenarios resembling epidemic settings such as the one that occurred in Chaparral, Colombia in 2004 demonstrate important economic benefits.
AB - Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Markov decision analytic computer model to evaluate the potential economic value of a preventative CL vaccine in seven countries in Latin America: Bolivia, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela. The results indicated that even a vaccine with a relatively short duration of protection and modest efficacy could be recommended for use in targeted locations, as it could prevent a substantial number of cases at low-cost and potentially even result in cost savings. If the population in the seven countries were vaccinated using a vaccine that provides at least 10 years of protection, an estimated 41,000-144,784 CL cases could be averted, each at a cost less than the cost of current recommended treatments. Further, even a vaccine providing as little as five years duration of protection with as little as 50% efficacy remains cost-effective compared with chemotherapy; additional scenarios resembling epidemic settings such as the one that occurred in Chaparral, Colombia in 2004 demonstrate important economic benefits.
KW - Cutaneous leishmaniasis
KW - Economics
KW - Latin America
KW - Vaccine
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U2 - 10.1016/j.vaccine.2012.11.032
DO - 10.1016/j.vaccine.2012.11.032
M3 - Article
C2 - 23176979
AN - SCOPUS:84871670712
SN - 0264-410X
VL - 31
SP - 480
EP - 486
JO - Vaccine
JF - Vaccine
IS - 3
ER -