The global impact and cost-effectiveness of a melioidosis vaccine

Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines...
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Autor*in:	Nantasit Luangasanatip [verfasserIn] Stefan Flasche [verfasserIn] David A. B. Dance [verfasserIn] Direk Limmathurotsakul [verfasserIn] Bart J. Currie [verfasserIn] Chiranjay Mukhopadhyay [verfasserIn] Tim Atkins [verfasserIn] Richard Titball [verfasserIn] Mark Jit [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation

Übergeordnetes Werk:	In: BMC Medicine - BMC, 2003, 17(2019), 1, Seite 11
Übergeordnetes Werk:	volume:17 ; year:2019 ; number:1 ; pages:11

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1186/s12916-019-1358-x

Katalog-ID:	DOAJ016913604

Internformat


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520			\|a Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission.
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700	0		\|a Direk Limmathurotsakul \|e verfasserin \|4 aut
700	0		\|a Bart J. Currie \|e verfasserin \|4 aut
700	0		\|a Chiranjay Mukhopadhyay \|e verfasserin \|4 aut
700	0		\|a Tim Atkins \|e verfasserin \|4 aut
700	0		\|a Richard Titball \|e verfasserin \|4 aut
700	0		\|a Mark Jit \|e verfasserin \|4 aut
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author_variant	n l nl s f sf d a b d dabd d l dl b j c bjc c m cm t a ta r t rt m j mj
matchkey_str	article:17417015:2019----::hgoaipcadotfetvnsoaei
hierarchy_sort_str	2019
publishDate	2019
allfields	10.1186/s12916-019-1358-x doi (DE-627)DOAJ016913604 (DE-599)DOAJ0d6d0d121fc44e6697f34b935c18b93d DE-627 ger DE-627 rakwb eng Nantasit Luangasanatip verfasserin aut The global impact and cost-effectiveness of a melioidosis vaccine 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission. Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation Medicine R Stefan Flasche verfasserin aut David A. B. Dance verfasserin aut Direk Limmathurotsakul verfasserin aut Bart J. Currie verfasserin aut Chiranjay Mukhopadhyay verfasserin aut Tim Atkins verfasserin aut Richard Titball verfasserin aut Mark Jit verfasserin aut In BMC Medicine BMC, 2003 17(2019), 1, Seite 11 (DE-627)377271225 (DE-600)2131669-7 17417015 nnns volume:17 year:2019 number:1 pages:11 https://doi.org/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/article/0d6d0d121fc44e6697f34b935c18b93d kostenfrei http://link.springer.com/article/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/toc/1741-7015 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2019 1 11
spelling	10.1186/s12916-019-1358-x doi (DE-627)DOAJ016913604 (DE-599)DOAJ0d6d0d121fc44e6697f34b935c18b93d DE-627 ger DE-627 rakwb eng Nantasit Luangasanatip verfasserin aut The global impact and cost-effectiveness of a melioidosis vaccine 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission. Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation Medicine R Stefan Flasche verfasserin aut David A. B. Dance verfasserin aut Direk Limmathurotsakul verfasserin aut Bart J. Currie verfasserin aut Chiranjay Mukhopadhyay verfasserin aut Tim Atkins verfasserin aut Richard Titball verfasserin aut Mark Jit verfasserin aut In BMC Medicine BMC, 2003 17(2019), 1, Seite 11 (DE-627)377271225 (DE-600)2131669-7 17417015 nnns volume:17 year:2019 number:1 pages:11 https://doi.org/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/article/0d6d0d121fc44e6697f34b935c18b93d kostenfrei http://link.springer.com/article/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/toc/1741-7015 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2019 1 11
allfields_unstemmed	10.1186/s12916-019-1358-x doi (DE-627)DOAJ016913604 (DE-599)DOAJ0d6d0d121fc44e6697f34b935c18b93d DE-627 ger DE-627 rakwb eng Nantasit Luangasanatip verfasserin aut The global impact and cost-effectiveness of a melioidosis vaccine 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission. Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation Medicine R Stefan Flasche verfasserin aut David A. B. Dance verfasserin aut Direk Limmathurotsakul verfasserin aut Bart J. Currie verfasserin aut Chiranjay Mukhopadhyay verfasserin aut Tim Atkins verfasserin aut Richard Titball verfasserin aut Mark Jit verfasserin aut In BMC Medicine BMC, 2003 17(2019), 1, Seite 11 (DE-627)377271225 (DE-600)2131669-7 17417015 nnns volume:17 year:2019 number:1 pages:11 https://doi.org/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/article/0d6d0d121fc44e6697f34b935c18b93d kostenfrei http://link.springer.com/article/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/toc/1741-7015 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2019 1 11
allfieldsGer	10.1186/s12916-019-1358-x doi (DE-627)DOAJ016913604 (DE-599)DOAJ0d6d0d121fc44e6697f34b935c18b93d DE-627 ger DE-627 rakwb eng Nantasit Luangasanatip verfasserin aut The global impact and cost-effectiveness of a melioidosis vaccine 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission. Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation Medicine R Stefan Flasche verfasserin aut David A. B. Dance verfasserin aut Direk Limmathurotsakul verfasserin aut Bart J. Currie verfasserin aut Chiranjay Mukhopadhyay verfasserin aut Tim Atkins verfasserin aut Richard Titball verfasserin aut Mark Jit verfasserin aut In BMC Medicine BMC, 2003 17(2019), 1, Seite 11 (DE-627)377271225 (DE-600)2131669-7 17417015 nnns volume:17 year:2019 number:1 pages:11 https://doi.org/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/article/0d6d0d121fc44e6697f34b935c18b93d kostenfrei http://link.springer.com/article/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/toc/1741-7015 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2019 1 11
allfieldsSound	10.1186/s12916-019-1358-x doi (DE-627)DOAJ016913604 (DE-599)DOAJ0d6d0d121fc44e6697f34b935c18b93d DE-627 ger DE-627 rakwb eng Nantasit Luangasanatip verfasserin aut The global impact and cost-effectiveness of a melioidosis vaccine 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission. Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation Medicine R Stefan Flasche verfasserin aut David A. B. Dance verfasserin aut Direk Limmathurotsakul verfasserin aut Bart J. Currie verfasserin aut Chiranjay Mukhopadhyay verfasserin aut Tim Atkins verfasserin aut Richard Titball verfasserin aut Mark Jit verfasserin aut In BMC Medicine BMC, 2003 17(2019), 1, Seite 11 (DE-627)377271225 (DE-600)2131669-7 17417015 nnns volume:17 year:2019 number:1 pages:11 https://doi.org/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/article/0d6d0d121fc44e6697f34b935c18b93d kostenfrei http://link.springer.com/article/10.1186/s12916-019-1358-x kostenfrei https://doaj.org/toc/1741-7015 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 17 2019 1 11
language	English
source	In BMC Medicine 17(2019), 1, Seite 11 volume:17 year:2019 number:1 pages:11
sourceStr	In BMC Medicine 17(2019), 1, Seite 11 volume:17 year:2019 number:1 pages:11
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation Medicine R
isfreeaccess_bool	true
container_title	BMC Medicine
authorswithroles_txt_mv	Nantasit Luangasanatip @@aut@@ Stefan Flasche @@aut@@ David A. B. Dance @@aut@@ Direk Limmathurotsakul @@aut@@ Bart J. Currie @@aut@@ Chiranjay Mukhopadhyay @@aut@@ Tim Atkins @@aut@@ Richard Titball @@aut@@ Mark Jit @@aut@@
publishDateDaySort_date	2019-01-01T00:00:00Z
hierarchy_top_id	377271225
id	DOAJ016913604
language_de	englisch
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Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. 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author	Nantasit Luangasanatip
spellingShingle	Nantasit Luangasanatip misc Melioidosis misc Infections misc Vaccine misc Cost-effectiveness misc Economic evaluation misc Medicine misc R The global impact and cost-effectiveness of a melioidosis vaccine
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topic_title	The global impact and cost-effectiveness of a melioidosis vaccine Melioidosis Infections Vaccine Cost-effectiveness Economic evaluation
topic	misc Melioidosis misc Infections misc Vaccine misc Cost-effectiveness misc Economic evaluation misc Medicine misc R
topic_unstemmed	misc Melioidosis misc Infections misc Vaccine misc Cost-effectiveness misc Economic evaluation misc Medicine misc R
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title	The global impact and cost-effectiveness of a melioidosis vaccine
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title_full	The global impact and cost-effectiveness of a melioidosis vaccine
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author_browse	Nantasit Luangasanatip Stefan Flasche David A. B. Dance Direk Limmathurotsakul Bart J. Currie Chiranjay Mukhopadhyay Tim Atkins Richard Titball Mark Jit
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title_sort	global impact and cost-effectiveness of a melioidosis vaccine
title_auth	The global impact and cost-effectiveness of a melioidosis vaccine
abstract	Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission.
abstractGer	Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission.
abstract_unstemmed	Abstract Background Every year, 90,000 people may die from melioidosis. Vaccine candidates have not proceeded past animal studies, partly due to uncertainty around the potential market size. This study aims to estimate the potential impact, cost-effectiveness and market size for melioidosis vaccines. Methods Age-structured decision tree models with country-specific inputs were used to estimate net costs and health benefits of vaccination, with health measured in quality-adjusted life years (QALYs). Four target groups of people living in endemic regions were considered: (i) people aged over 45 years with chronic renal disease, (ii) people aged over 45 years with diabetes, (iii) people aged over 45 years with diabetes and/or chronic renal disease, (iv) everyone aged over 45 years. Melioidosis risk was estimated using Bayesian evidence synthesis of 12 observational studies. In the base case, vaccines were assumed to have 80% efficacy, to have 5-year mean protective duration and to cost USD10.20–338.20 per vaccine. Results Vaccination could be cost-effective (with incremental cost-effectiveness ratio below GDP per capita) in 61/83 countries/territories with local melioidosis transmission. In these 61 countries/territories, vaccination could avert 68,000 lost QALYs, 8300 cases and 4400 deaths per vaccinated age cohort, at an incremental cost of USD59.6 million. Strategy (ii) was optimal in most regions. The vaccine market may be worth USD268 million per year at its threshold cost-effective price in each country/territory. Conclusions There is a viable melioidosis vaccine market, with cost-effective vaccine strategies in most countries/territories with local transmission.
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title_short	The global impact and cost-effectiveness of a melioidosis vaccine
url	https://doi.org/10.1186/s12916-019-1358-x https://doaj.org/article/0d6d0d121fc44e6697f34b935c18b93d http://link.springer.com/article/10.1186/s12916-019-1358-x https://doaj.org/toc/1741-7015
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The global impact and cost-effectiveness of a melioidosis vaccine

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