Vaccine-preventable haemophilus influenza type B disease burden and cost-effectiveness of infant vaccination in Indonesia

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. Hib pneumonia and meningitis incidences for children with access to health c...

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Bibliographic Details
Published in:The Pediatric infectious disease journal Vol. 27; no. 5; p. 438
Main Authors: 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
Format: Journal Article
Language:English
Published: United States 01.05.2008
Subjects:
Child, Preschool
Cost of Illness
Cost-Benefit Analysis
Haemophilus Infections - epidemiology
Haemophilus Infections - immunology
Haemophilus Infections - mortality
Haemophilus Infections - prevention & control
Haemophilus influenzae type b - immunology
Haemophilus Vaccines - economics
Haemophilus Vaccines - immunology
Health Care Costs - statistics & numerical data
Humans
Incidence
Indonesia - epidemiology
Infant
Infant, Newborn
Meningitis, Haemophilus - epidemiology
Meningitis, Haemophilus - microbiology
Meningitis, Haemophilus - prevention & control
Pneumonia - epidemiology
Pneumonia - microbiology
Pneumonia - prevention & control
Vaccination - economics
Vaccines, Conjugate - economics
Vaccines, Conjugate - immunology
Indonesia
ISSN:0891-3668
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Summary: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. 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. 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. 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.
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ISSN:0891-3668
DOI:10.1097/INF.0b013e318165f1ba