Cost-effectiveness of a national #enterovirus 71 #vaccination program in #China (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Cost-effectiveness of a national enterovirus 71 vaccination program in China

Wenjun Wang , Jianwen Song , Jingjing Wang , Yaping Li, Huiling Deng, Mei Li, Ning Gao, Song Zhai, Shuangsuo Dang , Xin Zhang, Xiaoli Jia

Published: September 11, 2017 / DOI: https://doi.org/10.1371/journal.pntd.0005899 / This is an uncorrected proof.

 

Abstract

Background and aims

Enterovirus 71 (EV71) has caused great morbidity, mortality, and use of health service in children younger than five years in China. Vaccines against EV71 have been proved effective and safe by recent phase 3 trials and are now available in China. The purpose of this study was to evaluate the health impact and cost-effectiveness of a national EV71 vaccination program in China.

Methods

Using Microsoft Excel, a decision model was built to calculate the net clinical and economic outcomes of EV71 vaccination compared with no EV71 vaccination in a birth cohort of 1,000,000 Chinese children followed for five years. Model parameters came from published epidemiology, clinical and cost data.

Results

In the base-case, vaccination would annually avert 37,872 cases of hand, foot and mouth disease (HFMD), 2,629 herpangina cases, 72,900 outpatient visits, 6,363 admissions to hospital, 29 deaths, and 945 disability adjusted life years. The break-even price of the vaccine was $5.2/dose. When the price was less than $8.3 or $14.6/dose, the vaccination program would be highly cost-effective or cost-effective, respectively (incremental cost-effectiveness ratio less than or between one to three times China GDP per capita, respectively). In one-way sensitivity analyses, the HFMD incidence was the only influential parameter at the price of $5/dose.

Conclusions

Within the price range of current routine vaccines paid by the government, a national EV71 vaccination program would be cost-saving or highly cost-effective to prevent EV71 related morbidity, mortality, and use of health service among children younger than five years in China. Policy makers should consider including EV71 vaccination as part of China’s routine childhood immunization schedule.

 

Author summary

Enterovirus 71 (EV71) has caused great morbidity, mortality, and use of health service in children younger than five years in China. Recently, effective and safe vaccines against EV71 have been approved. Whether EV71 vaccination should be included as part of China’s routine childhood immunization schedule is unknown. In this study, we built a decision model to evaluate the health impact and cost-effectiveness of a national EV71 vaccination program in China. We find that vaccination would annually avert 567,500 cases of hand, foot and mouth disease (HFMD), 40,000 herpangina cases, 1,093,500 outpatient visits, 95,500 admissions to hospital, 435 deaths, and 14,000 disability adjusted life years based on the current Chinese birth cohort size. The break-even price of the vaccine was $5.2/dose. Within the price range of current routine vaccines paid by the government, a national EV71 vaccination program would be cost-saving or highly cost-effective. Policy makers should consider including EV71 vaccination as part of China’s routine childhood immunization schedule.

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Citation: Wang W, Song J, Wang J, Li Y, Deng H, Li M, et al. (2017) Cost-effectiveness of a national enterovirus 71 vaccination program in China. PLoS Negl Trop Dis 11(9): e0005899. https://doi.org/10.1371/journal.pntd.0005899

Editor: Isaac Chun-Hai Fung, Georgia Southern University Jiann-Ping Hsu College of Public Health, UNITED STATES

Received: April 5, 2017; Accepted: August 23, 2017; Published: September 11, 2017

Copyright: © 2017 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Keywords: EV-71; Vaccines; China.

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Giuseppe Michieli

I am an Italian blogger, active since 2005 with main focus on emerging infectious diseases such as avian influenza, SARS, antibiotics resistance, and many other global Health issues. Other fields of interest are: climate change, global warming, geological and biological sciences. My activity consists mainly in collection and analysis of news, public services updates, confronting sources and making decision about what are the 'signals' of an impending crisis (an outbreak, for example). When a signal is detected, I follow traces during the entire course of an event. I started in 2005 my blog ''A TIME'S MEMORY'', now with more than 40,000 posts and 3 millions of web interactions. Subsequently I added an Italian Language blog, then discontinued because of very low traffic and interest. I contributed for seven years to a public forum (FluTrackers.com) in the midst of the Ebola epidemic in West Africa in 2014, I left the site to continue alone my data tracking job.