Cost-effectiveness of dengue vaccination in Yucatán, Mexico using a dynamic dengue transmission model

PLoS One. 2017 Apr 5;12(4):e0175020. doi: 10.1371/journal.pone.0175020. eCollection 2017.

Abstract

Background: The incidence of dengue fever (DF) is steadily increasing in Mexico, burdening health systems with consequent morbidities and mortalities. On December 9th, 2015, Mexico became the first country for which the dengue vaccine was approved for use. In anticipation of a vaccine rollout, analysis of the cost-effectiveness of the dengue vaccination program that quantifies the dynamics of disease transmission is essential.

Methods: We developed a dynamic transmission model of dengue in Yucatán, Mexico and its proposed vaccination program to incorporate herd immunity into our analysis of cost-effectiveness analysis. Our model also incorporates important characteristics of dengue epidemiology, such as clinical cross-immunity and susceptibility enhancement upon secondary infection. Using our model, we evaluated the cost-effectiveness and economic impact of an imperfect dengue vaccine in Yucatán, Mexico.

Conclusions: Our study indicates that a dengue vaccination program would prevent 90% of cases of symptomatic DF incidence as well as 90% of dengue hemorrhagic fever (DHF) incidence and dengue-related deaths annually. We conclude that a dengue vaccine program in Yucatán, Mexico would be very cost-effective as long as the vaccination cost per individual is less than $140 and $214 from health care and societal perspectives, respectively. Furthermore, at an exemplary vaccination cost of $250 USD per individual on average, dengue vaccination is likely to be cost-effective 43% and 88% of the time from health care and societal perspectives, respectively.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cost-Benefit Analysis
  • Dengue / economics
  • Dengue / epidemiology
  • Dengue / prevention & control*
  • Dengue / transmission
  • Dengue Vaccines / economics
  • Dengue Vaccines / therapeutic use*
  • Drug Costs / statistics & numerical data
  • Health Care Costs / statistics & numerical data
  • Humans
  • Mexico / epidemiology
  • Middle Aged
  • Models, Statistical
  • Young Adult

Substances

  • Dengue Vaccines

Grants and funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF; http://www.nrf.re.kr/nrf_eng_cms/) funded by the Ministry of Education (2015R1D1A1A01058208). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.