Population-level health and economic impacts of introducing Vaccae vaccination in China: a modelling study.
BMJ Glob Health
; 8(5)2023 05.
Article
en En
| MEDLINE
| ID: mdl-37257938
ABSTRACT
INTRODUCTION:
Given the ageing epidemic of tuberculosis (TB), China is facing an unprecedented opportunity provided by the first clinically approved next-generation TB vaccine Vaccae, which demonstrated 54.7% efficacy for preventing reactivation from latent infection in a phase III trial. We aim to assess the population-level health and economic impacts of introducing Vaccae vaccination to inform policy-makers.METHODS:
We evaluated a potential national Vaccae vaccination programme in China initiated in 2024, assuming 20 years of protection, 90% coverage and US$30/dose government contract price. An age-structured compartmental model was adapted to simulate three strategies (1) no Vaccae; (2) mass vaccination among people aged 15-74 years and (3) targeted vaccination among older adults (60 years). Cost analyses were conducted from the healthcare sector perspective, discounted at 3%.RESULTS:
Considering postinfection efficacy, targeted vaccination modestly reduced TB burden (~20%), preventing cumulative 8.01 (95% CI 5.82 to 11.8) million TB cases and 0.20 (0.17 to 0.26) million deaths over 2024-2050, at incremental cost-effectiveness ratio of US$4387 (2218 to 10 085) per disability adjusted life year averted. The implementation would require a total budget of US$22.5 (17.6 to 43.4) billion. In contrast, mass vaccination had a larger bigger impact on the TB epidemic, but the overall costs remained high. Although both preinfection and postinfection vaccine efficacy type might have a maximum impact (>40% incidence rate reduction in 2050), it is important that the vaccine price does not exceed US$5/dose.CONCLUSION:
Vaccae represents a robust and cost-effective choice for TB epidemic control in China. This study may facilitate the practice of evidence-based strategy plans for TB vaccination and reimbursement decision making.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
/
3_ND
/
4_TD
Problema de salud:
1_doencas_transmissiveis
/
2_enfermedades_transmissibles
/
3_neglected_diseases
/
3_tuberculosis
/
4_tuberculosis
Asunto principal:
Tuberculosis
/
Vacunas
Tipo de estudio:
Health_economic_evaluation
/
Prognostic_studies
Aspecto:
Patient_preference
Límite:
Aged
/
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
BMJ Glob Health
Año:
2023
Tipo del documento:
Article
País de afiliación:
China