TITLE

Is a HIV vaccine a viable option and at what price? An economic evaluation of adding HIV vaccination into existing prevention programs in Thailand

AUTHOR(S)
Leelahavarong, Pattara; Teerawattananon, Yot; Werayingyong, Pitsaphun; Akaleephan, Chutima; Premsri, Nakorn; Namwat, Chawetsan; Peerapatanapokin, Wiwat; Tangcharoensathien, Viroj
PUB. DATE
January 2011
SOURCE
BMC Public Health;2011, Vol. 11 Issue 1, p534
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: This study aims to determine the maximum price at which HIV vaccination is cost-effective in the Thai healthcare setting. It also aims to identify the relative importance of vaccine characteristics and risk behavior changes among vaccine recipients to determine how they affect this cost-effectiveness. Methods: A semi-Markov model was developed to estimate the costs and health outcomes of HIV prevention programs combined with HIV vaccination in comparison to the existing HIV prevention programs without vaccination. The estimation was based on a lifetime horizon period (99 years) and used the government perspective. The analysis focused on both the general population and specific high-risk population groups. The maximum price of cost-effective vaccination was defined by using threshold analysis; one-way and probabilistic sensitivity analyses were performed. The study employed an expected value of perfect information (EVPI) analysis to determine the relative importance of parameters and to prioritize future studies. Results: The most expensive HIV vaccination which is cost-effective when given to the general population was 12,000 Thai baht (US$1 = 34 Thai baht in 2009). This vaccination came with 70% vaccine efficacy and lifetime protection as long as risk behavior was unchanged post-vaccination. The vaccine would be considered costineffective at any price if it demonstrated low efficacy (30%) and if post-vaccination risk behavior increased by 10% or more, especially among the high-risk population groups. The incremental cost-effectiveness ratios were the most sensitive to change in post-vaccination risk behavior, followed by vaccine efficacy and duration of protection. The EVPI indicated the need to quantify vaccine efficacy, changed post-vaccination risk behavior, and the costs of vaccination programs. Conclusions: The approach used in this study differentiated it from other economic evaluations and can be applied for the economic evaluation of other health interventions not available in healthcare systems. This study is important not only for researchers conducting future HIV vaccine research but also for policy decision makers who, in the future, will consider vaccine adoption.
ACCESSION #
63973971

 

Related Articles

  • Efficacy of Vaccination against HPV Infections to Prevent Cervical Cancer in France: Present Assessment and Pathways to Improve Vaccination Policies. Ribassin-Majed, Laureen; Lounes, Rachid; Clémençon, Stephan // PLoS ONE;Mar2012, Vol. 7 Issue 3, p1 

    Background: Seventy percent of sexually active individuals will be infected with Human Papillomavirus (HPV) during their lifetime. These infections are incriminated for almost all cervical cancers. In France, 3,068 new cases of cervical cancer and 1,067 deaths from cervical cancer occurred in...

  • Cost and efficiency of public sector sexually transmitted infection clinics in Andhra Pradesh, India. Dandona, Lalit; Sisodia, Pratap; Prasad, TLN; Marseille, Elliot; Rao, M Chalapathi; Kumar, A Anod; Kumar, SG Prem; Ramesh, YK; Over, Mead; Someshwar, M; Kahn, James G // BMC Health Services Research;2005, Vol. 5, p69 

    Background: Control of sexually transmitted infections (STIs) is an important part of the effort to reduce the risk of HIV/AIDS. STI clinics in the government hospitals in India provide services predominantly to the poor. Data on the cost and efficiency of providing STI services in India are not...

  • Design and development of a new lentiviral based anti-HIV therapeutic vaccine. Rodriguez, M.; Sarry, E.; Bejanariu, A.; Casaban, L.; Abdalla, S.; Sabbah-Petrover, E.; Bauche, C. // Retrovirology;2012 Supplement, Vol. 9 Issue Suppl 2, p1 

    An abstract of the conference paper "Design and development of a new lentiviral based anti-HIV therapeutic vaccine," by E. Sarry and colleagues is presented.

  • High cost of Chlamydia can be cut, researcher finds. Silversides, Ann // CMAJ: Canadian Medical Association Journal;4/20/99, Vol. 160 Issue 8, p1119 

    Reports decrease in Chlamydia trachomatis infection health care cost through annual screening of women in Ontario, Canada. Diagnostic procedures used for C. trachomatis infection; Treatment cost of the infection; Prevalence of the infection among women; Advantages of nucleic acid amplification...

  • Rapidly progressive syphilis in early HIV infection. O'Mahony, Colm; Rodgers, Catherine A.; Mendelsohn, Shevaun S.; Sissons, Guy; McKay, Alasdair; Devine, John; Keeping, Iain M. // International Journal of STD & AIDS;Apr1997, Vol. 8 Issue 4, p275 

    The article presents a case study on the rapidly progressive syphilis in early HIV infection. The skin lesions are clinically indistinguishable from those of gumma. The pattern of infection in the patient showed something not typical of any of the usual stages of syphilis. It is therefore...

  • A systematic review of heterosexual anal intercourse and its role in the transmission of HIV and other sexually transmitted infections in Papua New Guinea. Kelly-Hanku, Angela; Vallely, Andrew; Wing Young Nicola Man; Wilson, David; Law, Greg; Gray, Richard // BMC Public Health;2013, Vol. 13 Issue 1, p1 

    Background Papua New Guinea (PNG) has a high burden of sexually transmitted infections (STIs) and the highest adult HIV prevalence in the Pacific region. Despite this burden of disease, heterosexual anal intercourse (HAI) has rarely been considered. Given the increasing number of, and interest...

  • A Glimpse of the Early Years of the Human Immunodeficiency Virus Epidemic: A Fellow's Experience in 2014. Colasanti, Jonathan; Armstrong, Wendy S. // Open Forum Infectious Diseases;Sep2014, Vol. 1 Issue 2, p1 

    Human immunodeficiency virus (HIV) is a manageable chronic disease in the United States, yet the first author's experience on a general infectious diseases (ID) consult service illustrates that certain areas of the United States still experience high rates of acquired immune deficiency...

  • Low Multiplicity of HIV-1 Infection and No Vaccine Enhancement in VAX003 Injection Drug Users. Sterrett, Sarah; Learn, Gerald H.; Edlefsen, Paul T.; Haynes, Barton F.; Hahn, Beatrice H.; Shaw, George M.; Bar, Katharine J. // Open Forum Infectious Diseases;Sep2014, Vol. 1 Issue 2, p1 

    Background. We performed human immunodeficiency virus type 1 (HIV-1) transmitted/founder (T/F) virus analysis of the VAX003 vaccine efficacy trial participants to characterize the transmission bottleneck and test for vaccine-associated reduction or enhancement of infection in this injection drug...

  • Estimation of the Prevalence of Undiagnosed and Diagnosed HIV in an Urban Emergency Department. Reichmann, William M.; Walensky, Rochelle P.; Case, Amy; Novais, Anna; Arbelaez, Christian; Katz, Jeffrey N.; Losina, Elena // PLoS ONE;2011, Vol. 6 Issue 11, p1 

    Objective: To estimate the prevalence of undiagnosed HIV, the prevalence of diagnosed HIV, and proportion of HIV that is undiagnosed in populations with similar demographics as the Universal Screening for HIV in the Emergency Room (USHER) Trial and the Brigham and Women's Hospital (BWH)...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics