دورية أكاديمية
Evaluating the potential cost-effectiveness of microarray patches to expand access to hepatitis B birth dose vaccination in low-and middle-income countries: A modelling study.
العنوان: | Evaluating the potential cost-effectiveness of microarray patches to expand access to hepatitis B birth dose vaccination in low-and middle-income countries: A modelling study. |
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المؤلفون: | Seaman CP; Burnet Institute, Melbourne, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia., Mvundura M; PATH, Seattle, Washington, United States of America., Frivold C; PATH, Seattle, Washington, United States of America., Morgan C; Burnet Institute, Melbourne, Australia.; Jhpiego, The Johns Hopkins University Affiliate, Baltimore, Maryland, United States of America.; School of Population and Global Health, University of Melbourne, Melbourne, Australia., Jarrahian C; PATH, Seattle, Washington, United States of America., Howell J; Burnet Institute, Melbourne, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.; Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.; Department of Medicine, University of Melbourne, Melbourne, Australia., Hellard M; Burnet Institute, Melbourne, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.; Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Australia.; Department of Infectious Diseases, The Alfred Hospital, Melbourne, Australia., Scott N; Burnet Institute, Melbourne, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. |
المصدر: | PLOS global public health [PLOS Glob Public Health] 2022 May 23; Vol. 2 (5), pp. e0000394. Date of Electronic Publication: 2022 May 23 (Print Publication: 2022). |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 9918283779606676 Publication Model: eCollection Cited Medium: Internet ISSN: 2767-3375 (Electronic) Linking ISSN: 27673375 NLM ISO Abbreviation: PLOS Glob Public Health Subsets: PubMed not MEDLINE |
أسماء مطبوعة: | Original Publication: San Francisco, California : Public Library of Science, [2021]- |
مستخلص: | Timely birth dose vaccination is key for achieving elimination of hepatitis B, however, programmatic requirements for delivering current vaccine presentations to births outside of health facilities inhibits coverage within many low-and middle-income countries (LMICs). Vaccine technologies in development such as microarray patches (MAPs) could assist in overcoming these barriers, but procurement could incur higher per-dose commodity costs than current ten-dose (US$0.34) and single-dose (US$0.62) vial presentations, necessitating an evaluation of the economic value proposition for MAPs. Within 80 LMICs offering universal hepatitis B birth dose vaccination, the cost-effectiveness of using MAPs to expand coverage was evaluated using a mathematical model. We considered three potential per dose MAP prices (US$1.65, US$3.30, and US$5.00), and two potential MAP use-cases: (1) MAPs are used by lay-health workers to expand birth dose coverage outside of health facility settings, and (2) MAPs are also preferred by qualified health workers, replacing a proportion of existing coverage from vaccine vials. Analysis took the health system perspective, was costed in 2020 US$, and discounted at 3% annually. Across minimal (1% additional coverage) and maximal (10% additional and 10% replacement coverage) MAP usage scenarios, between 2.5 (interquartile range [IQR]: 1.9, 3.1) and 38 (IQR: 28,44) thousand DALYs were averted over the estimated 2020 birth cohort lifetime in 80 LMICs. Efficiency of MAPs was greatest when used to provide additional coverage (scenario 1), on average saving US$88.65 ($15.44, $171.22) per DALY averted at a price of US$5.00 per MAP. Efficiency was reduced when used to replace existing coverage (scenario 2); however, at prices up to US$5.00 per MAP, we estimate this use-case could remain cost-effective in at least 73 (91%) modelled LMICs. Our findings suggest even at higher procurement costs, MAPs are likely to represent a highly cost-effective or cost-saving mechanism to expand reach of birth dose vaccination in LMICs. Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: MEH receives funding from Gilead Sciences and AbbVie, Inc for investigator-initiated research unrelated to this topic. JH has received speaker fees from Gilead Sciences and Eisai, sits on an advisory board for Gilead Sciences and has received investigator initiated competitive grant funding from Gilead Sciences and Eisai, all unrelated to this topic. All other authors (CPS, MM, CF, CJ, CM, NS) have no conflicts of interest to declare. (Copyright: © 2022 Seaman 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.) |
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تواريخ الأحداث: | Date Created: 20230324 Latest Revision: 20230327 |
رمز التحديث: | 20231215 |
مُعرف محوري في PubMed: | PMC10021446 |
DOI: | 10.1371/journal.pgph.0000394 |
PMID: | 36962423 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2767-3375 |
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DOI: | 10.1371/journal.pgph.0000394 |