An economic evaluation of the introduction of Haemophilus influenzae type B vaccine in Vietnam, including its impact on high-risk HIV-infected children
Objectives: (1) to calculate the average total treatment costs for under-five pneumonia and meningitis patients from the health sector, household and society perspectives; (2) to analyze the cost-effectiveness of the introduction of the Haemophilus influenzae type b (Hib) conjugate vaccine in Vietnam from the societal perspective, including a preliminary assessment of the impact of Human Immunodeficiency Virus (HIV) infection. Study design: A prospective study was conducted to achieve the first objective. A static cohort model was developed to estimate the incremental cost-effectiveness ratios. Study population and sample size: the 2011 Vietnam live birth cohort was used for the model. In addition, the birth cohort was assumed to have 2,000 HIV-infected children to assess the effect of HIV infection. A survey was conducted with 180 pneumonia patients and 15 meningitis patients aged from 1-59 months admitted to the Department of Pediatrics in Bach Mai Hospital between March-December 2012. Data sources: Government reports, epidemiological and vaccine-related parameters from local studies and relevant data in the literature, medical record reviews of selected patients and personal interviews with their caregivers. Data analysis: Summary statistics were presented for average treatment cost estimates. Results for cost-effectiveness analysis were presented as incremental cost per Hib case averted, per Hib death prevented and per DALY averted. Results: From the health sector perspective, the average total treatment costs were US$ 179.62 (SD, US$ 84.72) for treating pneumonia and US$ 299.80 (SD, US$ 350.37) for treating meningitis. The average total household costs were US$ 263.35 and US$ 442.03 for pneumonia and meningitis, respectively. From the societal perspective, the average total treatment costs for pneumonia was US$ 295.57 (SD, US$ 174.85) and for meningitis US$ 710.60 (SD, US$ 835.41). The base-case ICERs per discounted case, death and DALY prevented were US$ 774, US$ 4,075 and US$ 199, respectively. When taking HIV infection into account, the incremental cost-effectiveness ratios were US$ 1,986/discounted Hib case and US$ 10,484/discounted Hib death. Conclusions: Pneumonia and meningitis imposed a huge economic cost to the whole society. The new Hib vaccine program was highly cost-effective compared to WHO's recommended threshold.
Public health|Health care management
Le, Phuc Hong, "An economic evaluation of the introduction of Haemophilus influenzae type B vaccine in Vietnam, including its impact on high-risk HIV-infected children" (2013). Texas Medical Center Dissertations (via ProQuest). AAI3604544.