Abstract
Background: Most of Asia, including Indonesia, does not use Haemophilus influenzae type b (Hib) conjugate vaccines. We estimated total vaccine-preventable disease burden and the cost-effectiveness of Hib conjugate vaccine in Indonesia. Methods: Hib pneumonia and meningitis incidences for children with access to health care were derived from a randomized vaccine probe study on Lombok Island, Indonesia during 1998 "2002. Incidences were adjusted for limited access to care. Health system and patient out-of-pocket treatment cost data were collected concurrent with the probe study. For Hib vaccine in monovalent and combined (with DTP-HepB) presentations, we used 2007 UNICEF vaccine prices of US$3.30 and $3.75 per dose. Results: For the 2007 Indonesian birth cohort, Hib vaccine would prevent meningitis in 1 of every 179 children, pneumonia in 1 of every 18 children, and 4.9% of mortality among those younger than 5 years. The total incremental societal costs of introducing Hib vaccine in monovalent and pentavalent presentations were, respectively, US$11.74 and $8.93 per child vaccinated. Annual discounted treatment costs averted amounted to 20% of pentavalent vaccine costs. For the pentavalent vaccine, the incremental costs per discounted death and disability adjusted life-year averted amounted to US$3102 and $74, respectively, versus $4438 and $102 for monovalent vaccine. Conclusions: Routine infant Hib vaccination would prevent a large burden of pediatric illness and death in Indonesia. Even without external funding support, Hib vaccine will be a highly cost-effective intervention in either a monovalent or pentavalent presentation based on commonly used benchmarks.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 438-443 |
| Number of pages | 6 |
| Journal | Pediatric Infectious Disease Journal |
| Volume | 27 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2008 |
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Keywords
- cost effectiveness
- Haemophilus influenzae type b
- Indonesia
- vaccine
- vaccine effectiveness
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Infectious Diseases
- Microbiology (medical)
Cite this
Vaccine-preventable haemophilus influenza type B disease burden and cost-effectiveness of infant vaccination in Indonesia. / Gessner, Bradford D.; Sedyaningsih, Endang R.; Griffiths, Ulla K.; Sutanto, Agustinus; Linehan, Mary; Mercer, Dave; Mulholland, Edward Kim; Walker, Damian G.; Steinhoff, Mark; Nadjib, Mardiati.
In: Pediatric Infectious Disease Journal, Vol. 27, No. 5, 05.2008, p. 438-443.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Vaccine-preventable haemophilus influenza type B disease burden and cost-effectiveness of infant vaccination in Indonesia
AU - Gessner, Bradford D.
AU - Sedyaningsih, Endang R.
AU - Griffiths, Ulla K.
AU - Sutanto, Agustinus
AU - Linehan, Mary
AU - Mercer, Dave
AU - Mulholland, Edward Kim
AU - Walker, Damian G.
AU - Steinhoff, Mark
AU - Nadjib, Mardiati
PY - 2008/5
Y1 - 2008/5
N2 - Background: Most of Asia, including Indonesia, does not use Haemophilus influenzae type b (Hib) conjugate vaccines. We estimated total vaccine-preventable disease burden and the cost-effectiveness of Hib conjugate vaccine in Indonesia. Methods: Hib pneumonia and meningitis incidences for children with access to health care were derived from a randomized vaccine probe study on Lombok Island, Indonesia during 1998 "2002. Incidences were adjusted for limited access to care. Health system and patient out-of-pocket treatment cost data were collected concurrent with the probe study. For Hib vaccine in monovalent and combined (with DTP-HepB) presentations, we used 2007 UNICEF vaccine prices of US$3.30 and $3.75 per dose. Results: For the 2007 Indonesian birth cohort, Hib vaccine would prevent meningitis in 1 of every 179 children, pneumonia in 1 of every 18 children, and 4.9% of mortality among those younger than 5 years. The total incremental societal costs of introducing Hib vaccine in monovalent and pentavalent presentations were, respectively, US$11.74 and $8.93 per child vaccinated. Annual discounted treatment costs averted amounted to 20% of pentavalent vaccine costs. For the pentavalent vaccine, the incremental costs per discounted death and disability adjusted life-year averted amounted to US$3102 and $74, respectively, versus $4438 and $102 for monovalent vaccine. Conclusions: Routine infant Hib vaccination would prevent a large burden of pediatric illness and death in Indonesia. Even without external funding support, Hib vaccine will be a highly cost-effective intervention in either a monovalent or pentavalent presentation based on commonly used benchmarks.
AB - Background: Most of Asia, including Indonesia, does not use Haemophilus influenzae type b (Hib) conjugate vaccines. We estimated total vaccine-preventable disease burden and the cost-effectiveness of Hib conjugate vaccine in Indonesia. Methods: Hib pneumonia and meningitis incidences for children with access to health care were derived from a randomized vaccine probe study on Lombok Island, Indonesia during 1998 "2002. Incidences were adjusted for limited access to care. Health system and patient out-of-pocket treatment cost data were collected concurrent with the probe study. For Hib vaccine in monovalent and combined (with DTP-HepB) presentations, we used 2007 UNICEF vaccine prices of US$3.30 and $3.75 per dose. Results: For the 2007 Indonesian birth cohort, Hib vaccine would prevent meningitis in 1 of every 179 children, pneumonia in 1 of every 18 children, and 4.9% of mortality among those younger than 5 years. The total incremental societal costs of introducing Hib vaccine in monovalent and pentavalent presentations were, respectively, US$11.74 and $8.93 per child vaccinated. Annual discounted treatment costs averted amounted to 20% of pentavalent vaccine costs. For the pentavalent vaccine, the incremental costs per discounted death and disability adjusted life-year averted amounted to US$3102 and $74, respectively, versus $4438 and $102 for monovalent vaccine. Conclusions: Routine infant Hib vaccination would prevent a large burden of pediatric illness and death in Indonesia. Even without external funding support, Hib vaccine will be a highly cost-effective intervention in either a monovalent or pentavalent presentation based on commonly used benchmarks.
KW - cost effectiveness
KW - Haemophilus influenzae type b
KW - Indonesia
KW - vaccine
KW - vaccine effectiveness
UR - http://www.scopus.com/inward/record.url?scp=45849099512&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=45849099512&partnerID=8YFLogxK
U2 - 10.1097/INF.0b013e318165f1ba
DO - 10.1097/INF.0b013e318165f1ba
M3 - Article
C2 - 18398383
AN - SCOPUS:45849099512
VL - 27
SP - 438
EP - 443
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
SN - 0891-3668
IS - 5
ER -