An economic evaluation ofWolbachiadeployments for dengue control in Vietnam

Abstract

Background Dengue is a major public health challenge and a growing problem due to climate change. The release of Aedes aegypti mosquitoes infected with the intracellular bacterium Wolbachia is a novel form of vector control against dengue. However, there remains a need to evaluate the benefits of such an intervention at a large scale. In this paper, we evaluate the potential economic impact and cost-effectiveness of scaled Wolbachia deployments as a form of dengue control in Vietnam - targeted at the highest burden urban areas. Methods Ten settings within Vietnam were identified as priority locations for potential future Wolbachia deployments (using a population replacement strategy). The effectiveness of Wolbachia deployments in reducing the incidence of symptomatic dengue cases was assumed to be 75%. We assumed that the intervention would maintain this effectiveness for at least 20 years (but tested this assumption in the sensitivity analysis). A cost-utility analysis and cost-benefit analysis were conducted. Results From the health sector perspective, the Wolbachia intervention was projected to cost US$420 per disability-adjusted life year (DALY) averted. From the societal perspective, the overall cost-effectiveness ratio was negative, i.e. the economic benefits outweighed the costs. These results are contingent on the long-term effectiveness of Wolbachia releases being sustained for 20 years. However, the intervention was still classed as cost-effective across the majority of the settings when assuming only 10 years of benefits. Conclusion Overall, we found that targeting high burden cities with Wolbachia deployments would be a cost-effective intervention in Vietnam and generate notable broader benefits besides health gains.

Simulation-based economic evaluation of the Wolbachia method in Brazil: a cost-effective strategy for dengue control

“…Even under scenarios that resulted in a net positive incremental cost of the intervention in some cities and time frames, the intervention was still found to be cost-effective. These results are consistent with previous international studies in Indonesia 45 and Vietnam, 46 where the Wolbachia method was also found to be cost-effective. Considering the cost-effectiveness criteria adopted by the Brazilian National Commission for the Incorporation of Technology in the SUS (CONITEC) for neglected diseases (BRL 120 thousand per DALY), the results of the Wolbachia method would fall far below this threshold.…”

Economic optimization of Wolbachia‐infected Aedes aegypti release to prevent dengue

“…Post hoc quantification of the cost-effectiveness of dengue control through releases of Wolbachia-infected mosquitoes in Yogyakarta found that releases were cost-effective, costing approximately US$1500 per DALY averted. 40 Additional modeling studies examining the potential cost-effectiveness of theoretical releases in Singapore and Thailand found that programs would be cost-effective, costing US$50 000-100 000 42 and US$343-420 65,66 per DALY averted, respectively. While these results are not directly comparable with the results presented here, and come from a dengue-endemic region, it highlights the low costs associated with Wolbachia releases compared to the cost of dengue infection.…”

Wastewater surveillance and Wolbachia-aedes method to combat Zika virus outbreaks in tropical countries

“…6 In recent years, the Wolbachia programme has been extensively studied in both large cities and tropical, resource-constrained regions, and has been found both efficacious in limiting the spread of Aedes-transmitted arboviruses and costeffective as a population-level strategy. [5][6][7]…”