Microarray patch vaccines for typhoid conjugate vaccines: A global cost-effectiveness analysis

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-04-03 DOI:10.1016/j.vaccine.2025.127055

Marina Antillon , Anna Verjans , Fayad El Sheikh , Tiziana Scarna , Mercy Mvundura

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引用次数: 0

Abstract

A novel typhoid conjugate vaccine (TCV) presentation, the microarray patch (MAP), is in early-stage development and could potentially help to increase coverage in hard-to-reach populations beyond what is being achieved with the current TCV in a vial presentation administered with a needle and syringe (TCV-N&S). However, TCV-MAPs may come at a higher price per dose than TCV-N&S. Our analysis evaluated the potential cost-effectiveness of TCV-MAPs alongside TCV-N&S compared to TCV-N&S alone.

A global extended cost-effectiveness analysis, taking a health care perspective, was conducted for 133 low- to upper-middle-income countries for a time horizon of 20 years (2033–2052). Health outcomes were expressed in disability-adjusted life years (DALYs) and costs in 2021 US dollars, both discounted at 3 %. We assumed TCV-MAP would cost 1.33 to 3 times the price of the TCV-N&S vaccine. We calculated incremental cost-effectiveness ratios and evaluated them against various cost-effectiveness thresholds. For five selected countries, we conducted an additional subnational analysis to understand the potential value of a district-specific TCV-MAP implementation instead of a national rollout.

Across the 133 low- to upper-middle-income countries, national rollout of TCV-MAPs could avert an additional 5.2 million cases, 47,000 deaths, and 2.4 million DALYs compared to TCV-N&S only, at an additional cost of US$3.5 billion over 20 years. The largest proportion of the averted burden would be in the sub-Saharan African region. TCV-MAPs could be cost-effective in 33 % of the countries but in 78 % of sub-Saharan African countries. A subnational implementation could benefit some countries for which a national implementation may not be cost-effective, averting 2–15 % of cases for less than 1–3 % of the additional cost as compared to a national rollout. MAP price was a key driver of the results.

Regional or subnational implementation, coupled with a lower price point, could significantly improve the TCV-MAP value proposition.

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伤寒结合疫苗的微阵列贴片疫苗：全球成本效益分析

一种新型伤寒结合疫苗（TCV），即微阵列贴片（MAP），正处于早期开发阶段，可能有助于提高在难以接触到的人群中的覆盖率，超过目前用针和注射器给药的小瓶TCV （TCV- n&；S）。然而，TCV-MAPs每剂量的价格可能高于tcv - n & &；S。我们的分析评估了TCV-MAPs与TCV-N&；S联合使用的潜在成本效益，与单独使用TCV-N&；S相比。从卫生保健的角度，对133个低收入至中高收入国家进行了为期20年（2033-2052年）的全球扩展成本效益分析。健康结果以残疾调整生命年（DALYs）表示，成本以2021美元表示，均以3%折现。我们假设TCV-MAP的价格是TCV-N&；S疫苗价格的1.33到3倍。我们计算了增量成本效益比，并根据不同的成本效益阈值对其进行了评估。对于五个选定的国家，我们进行了额外的次国家分析，以了解具体地区实施TCV-MAP而不是全国推广的潜在价值。在133个低收入和中高收入国家中，与仅采用tcv - n - S相比，在全国范围内推广tcv - map可避免520万例病例、4.7万例死亡和240万伤残调整生命年，在20年内额外花费35亿美元。避免负担的最大比例将在撒哈拉以南非洲区域。TCV-MAPs在33%的国家具有成本效益，但在78%的撒哈拉以南非洲国家具有成本效益。次国家层面的实施可使一些国家受益，因为国家层面的实施可能不具有成本效益，与国家层面的推广相比，可避免2 - 15%的病例，而额外费用不到1 - 3%。MAP价格是结果的关键驱动因素。区域或地方实施，加上较低的价格点，可以显著改善TCV-MAP的价值主张。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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