Iara C Endo1, Patricia K Ziegelmann2, Anita Patel3. 1. Ministry of Planning, Development and Management, Brasilia, Brazil; Ministry of Health, Brasilia, Brazil. Electronic address: iara.endo@gmail.com. 2. Statistics Department, Mathematics Institute and Epidemiology Postgraduate Programme, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. 3. Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Abstract
BACKGROUND: Dengue fever is one of the most rapidly advancing viral vector-borne diseases worldwide and vaccine candidates are in the final stages of clinical trials, representing a decisive opportunity to control the disease. To decide whether and where to support the introduction of new vaccines it is crucial to assess costs imposed by the disease and cost-effectiveness of vaccine programmes. OBJECTIVE: To identify economic evidence about dengue fever immunization, by systematic review, to assist future policy decisions and investment. METHODS: The electronic search stage was conducted on PubMed/Medline, Embase, Web of Science, Global Health, NHS Economic Evaluation Database (NHS EED) and Latin American and Caribbean Health Sciences Literature (LILACS) databases. Searches were restricted to papers published between January 1970 and February 2016. Selected papers were quality assessed using three recognized checklists. RESULTS: Eleven relevant studies were identified and there is economic evidence of a satisfactory quality level, derived through modelling approaches, to conclude that dengue fever vaccines will be economically advantageous when compared to vector preventive strategies, despite uncertainties surrounding vaccine efficacy and costs per vaccine dose. Quality assessment based on checklists showed similar findings and although overall quality was considered satisfactory, there were relevant methodological issues not considered among studies reviewed. CONCLUSION: Several uncertainties still remain about effectiveness of dengue fever vaccines; however, the reviewed economic evidence suggests that, when available, the vaccine can be economically advantageous at moderate prices. Future research needs to confirm findings from the economic models by using actual costs and effectiveness data. Copyright Â
BACKGROUND: Dengue fever is one of the most rapidly advancing viral vector-borne diseases worldwide and vaccine candidates are in the final stages of clinical trials, representing a decisive opportunity to control the disease. To decide whether and where to support the introduction of new vaccines it is crucial to assess costs imposed by the disease and cost-effectiveness of vaccine programmes. OBJECTIVE: To identify economic evidence about dengue fever immunization, by systematic review, to assist future policy decisions and investment. METHODS: The electronic search stage was conducted on PubMed/Medline, Embase, Web of Science, Global Health, NHS Economic Evaluation Database (NHS EED) and Latin American and Caribbean Health Sciences Literature (LILACS) databases. Searches were restricted to papers published between January 1970 and February 2016. Selected papers were quality assessed using three recognized checklists. RESULTS: Eleven relevant studies were identified and there is economic evidence of a satisfactory quality level, derived through modelling approaches, to conclude that dengue fever vaccines will be economically advantageous when compared to vector preventive strategies, despite uncertainties surrounding vaccine efficacy and costs per vaccine dose. Quality assessment based on checklists showed similar findings and although overall quality was considered satisfactory, there were relevant methodological issues not considered among studies reviewed. CONCLUSION: Several uncertainties still remain about effectiveness of dengue fever vaccines; however, the reviewed economic evidence suggests that, when available, the vaccine can be economically advantageous at moderate prices. Future research needs to confirm findings from the economic models by using actual costs and effectiveness data. Copyright Â