Application of a cost-effectiveness analysis of pathogen-specific vaccines against gastroenteritis to a military population in a developing country setting. Issue 10 (28th February 2020)

• Record Type: Journal Article
• Authors: Ballard, Sarah-Blythe; Tallant, Aaron; Guerra, Rosio G.; Quigley, Dawn; Stiegmann, Regan; Mirelman, Andrew J.; Riddle, Mark S.; Gilman, Robert H.
• Is Part Of: Vaccine. Volume 38:Issue 10(2020)
• Page Start: 2292
• Page End: 2297
• Publication Date: 2020-02-28
• Subjects: Gastroenteritis -- Vaccine -- Cost-effectiveness analysis -- Low- and middle-income countries -- Military -- Peru; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2020.01.075
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Vaccine cost-effectiveness modeling can inform LMIC military health policies. Enteropathogen vaccines may be cost-effective for special LMIC adult populations. Shigella and norovirus vaccines appear cost-effective for Peruvian troops. Abstract: Vaccine implementation planning in low- and middle-income countries (LMIC) often focuses on children without considering special adult populations. We adapted an economic model developed by the United States Department of Defense (DoD) to evaluate the cost-effectiveness of vaccine acquisition strategies for Campylobacter-, ETEC-, Shigella-, and norovirus-associated gastroenteritis. We compared implementation costs with current medical management in the Peruvian armed forces, a special population of low- and middle-income (LMIC) adults with a high incidence of infectious gastroenteritis. Pathogen-specific vaccine implementation resulted in calculated cost-effectiveness ratio (CER) per duty day lost averted (CERDDL ) of $13, 741; $1, 272; $301; and $803, and a CER per diarrhea day averted of $2, 130; $215; $51; and $199 for Campylobacter, ETEC, Shigella, and norovirus, respectively. These estimates compare favorably to CERDDL estimates from high-income military population and suggest that implementing vaccines gastroenteritis may be cost-effective in the Peruvian military population.