The Economic Value of a Visceral Leishmaniasis Vaccine in Bihar State, India

Abstract

Abstract. Visceral leishmaniasis (VL) is responsible for substantial morbidity and mortality and current available treatments have many limitations. The ability of VL infection to generate life-long immunity offers promise for the development of a VL vaccine. A VL vaccine candidate has recently completed phase I clinical trials. We constructed a computer simulation model to determine the potential economic value of a VL vaccine in the endemic region of Bihar state, India. Results found a potential vaccine to be cost-effective (and in many cases economically dominant, i.e., saving costs and providing health benefits) throughout a wide range of vaccination costs, vaccine efficacies, and VL risks. Overall, our study strongly supports the continued development of a VL vaccine.

Progress in the Mathematical Modelling of Visceral Leishmaniasis

“…This latter vaccine type is currently the a promising candidate for use in the near future; however asymptomatic individuals who do not develop KA may still remain infectious, so there may possibly be less indirect protection to the Figure 13: This diagram shows the incremental cost-effectiveness ratio (ICER) compared to the per capita GDP in Bihar . It also shows the ranges given by Lee et al (2012) for "highly cost-effective", "cost-effective" and "not cost-effective".…”

“…Lee et al (2012) use a cost-effectiveness analysis to address the potential impact of a human vaccine for VL. Unlike the other cost-effectiveness papers which examine the cost-effectiveness per death averted (Boelaert et al, 1999;Meheus et al, 2010), Lee et al use disability adjusted life years (DALYs) avoided as their measure.…”

“…Finally, as is often the case with cost-benefit analyses, some models (Boelaert et al, 1999;Meheus et al, 2010;Lee et al, 2012) do not use a dynamic, prevalence-dependent ROI and so the role of vectors is not considered at all.…”

Evaluation of adjuvant activity of fractions derived from Agaricus blazei, when in association with the recombinant LiHyp1 protein, to protect against visceral leishmaniasis

“…Therefore, the development of new strategies to prevent leishmaniasis has become a high-priority Lee et al, 2012).…”

Visceral Leishmaniasis Control and Elimination: Is There a Role for Vaccines in Achieving Regional and Global Goals?

“…For example, an initial model determined that a VL vaccine would be highly cost-effective, regardless of duration of protection if the cost per dose is $5 or less and efficacy is at least 70%. 35 Some basic preferred product characteristics, which could then be further developed into a full TPP in the future, TABLE 3 VL vaccine development consideration TPP should consider a prophylactic vaccine against VL and a therapeutic vaccine as adjunctive therapy for PKDL. Increased understanding of vector biology is needed for transmission-blocking vaccine development.…”