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Cost benefit analysis of Japanese encephalitis vaccination program in Thailand
T Siraprapasiri1, W Sawaddiwudhipong, S Rojanasuphot
1Lampang Provincial Health Office, Ministry of Public Health, Lampang, Thailand.
Insights
Implementing the Japanese encephalitis (JE) vaccination program in Thai children at 18 months is more cost-effective than at 6 years. This JE immunization strategy offers significant health and economic benefits, preventing cases and reducing long-term care costs.
Area of Science:
- Public Health
- Epidemiology
- Health Economics
Background:
- Japanese encephalitis (JE) poses a significant public health threat, particularly in endemic regions like Thailand.
- Vaccination is a key strategy for controlling JE transmission and preventing associated morbidity and mortality.
Purpose of the Study:
- To estimate the benefits, risks, and costs of implementing a JE vaccination program in children aged 18 months and 6 years in Thailand.
- To compare the cost-effectiveness of JE vaccination at two different age points.
Main Methods:
- Decision analysis modeling was employed to evaluate the economic impact of JE vaccination programs.
- Costs included vaccine procurement, administration, and societal costs associated with JE cases (treatment, disability, lost earnings).
- Cost-effectiveness and cost-benefit analyses were conducted.
Main Results:
- The JE vaccination program at 18 months costs $2.16 per person, while at 6 years it costs $3.68 per person.
- The 18-month program is projected to prevent 124 JE cases, and the 6-year program 153 cases.
- The 18-month program demonstrates superior cost-effectiveness ($15,715 per case prevented) compared to the 6-year program ($21,661 per case prevented).
- The 18-month program yields higher savings ($72,922 per JE case prevented) than the 6-year program ($66,197 per JE case prevented).
Conclusions:
- The Japanese encephalitis vaccination program is cost-beneficial in Thailand under baseline assumptions.
- Implementing JE vaccination at 18 months is more cost-effective and yields greater economic benefits than at 6 years.
- The program remains justifiable unless JE incidence falls below 3 per 100,000 population, necessitating potential vaccine cost reductions.
Abstract:
Using decision analysis, we estimated benefits, risks, and costs of implementing the Japanese encephalitis (JE) vaccination program in children aged 18 months and 6 years in Thailand. The costs for inclusion of JE vaccine into the routine immunization program at 18 months and 6 years are $2.16 and $3.68 per person, respectively. In the baseline model, the JE vaccination program will prevent 124 JE cases in the program for 18 months old children and 153 JE cases in the program for 6 years old children. The 18 month child program is more cost-effective than the 6 year child program. The cost-effectiveness ratio in the 18 month child program is $15,715 compared with $21,661 in the 6 year child program. The benefits of the JE vaccination program are the savings in treatment cost, disability care, and the future lifetime earnings from JE prevented. The 18 month child program will save $72,922 per one prevented JE compared with $66,197 in the 6 year child program. The JE vaccination program is cost-beneficial under the base-case assumption. Sensitivity analysis which alters various assumptions indicates that the JE vaccination program is worth implementing unless the incidence of JE is less than 3 per 100,000 population. Otherwise, the cost of vaccine has to be reduced.