The potential economic value of a cutaneous leishmaniasis vaccine in seven endemic countries in the Americas

Abstract

Cutaneous leishmaniasis (CL) and its associated complications, including mucocutaneous leishmaniasis (MCL) and diffuse CL (DCL) have emerged as important neglected tropical diseases in Latin America, especially in areas associated with human migration, conflict, and recent deforestation. Because of the limitations of current chemotherapeutic approaches to CL, MCL, and DCL, several prototype vaccines are in different states of product and clinical development. We constructed and utilized a Markov decision analytic computer model to evaluate the potential economic value of a preventative CL vaccine in seven countries in Latin America: Bolivia, Brazil, Colombia, Ecuador, Mexico, Peru, and Venezuela. The results indicated that even a vaccine with a relative short duration of protection and modest efficacy could be recommended for use in targeted locations, as it could prevent a substantial number of cases at low-cost and potentially even result in cost savings. If the population in the seven countries were vaccinated using a vaccine that provides at least 10 years of protection, an estimated 41,000-144,784 CL cases could be averted, each at a cost less than the cost of current recommended treatments. Further, even a vaccine providing as little as five years duration of protection with as little as 50% efficacy remains cost-effective compared with chemotherapy; additional scenarios resembling epidemic settings such as the one that occurred in Chaparral, Colombia in 2004 demonstrates important economic benefits.

Sandfly and Leishmaniasis: A Review

“…Vaccine provides 5 years of protection and 50% efficacy [48]. In Bihar State similar study for visceral leishmaniasis also confirmed the cost effectiveness of vaccine [48]. The development of vaccine is under processing.…”

“…Bacon [48] describes that if population of Venezuela, Peru, Colombia, Ecuador, Mexico, Brazil and Bolivia were vaccinated through vaccine than it would provide ten years of protection, 41,000-144,000 cases of cutaneous leishmaniasis could be averted, and this would be lower cost than other treatments. Vaccine provides 5 years of protection and 50% efficacy [48]. In Bihar State similar study for visceral leishmaniasis also confirmed the cost effectiveness of vaccine [48].…”

Not All Antigens Are Created Equally: Progress, Challenges, and Lessons Associated with Developing a Vaccine for Leishmaniasis

“…Escherichia coli and yeast are among the most widely used systems for the production of recombinant proteins (22)(23)(24), and bioinformatics has facilitated the production of a variety of recombinant proteins that have been investigated as Leishmania vaccine antigen candidates in animal models (15,20). Key to the use of recombinant proteins is the cost-effectiveness of production, an important consideration when modeling has shown that a cost of $2 or less per dose for a preventive vaccine would be economically advantageous over the currently available leishmaniasis treatments (25). In addition, recombinant methods also provide the opportunity to manipulate and combine complementary proteins/epitopes in a single gene product.…”

Economic and Financial Evaluation of Neglected Tropical Diseases

“…Four studies evaluated on leishmaniasis (two on visceral and two on cutaneous): two evaluated treatment and two evaluated potential vaccines (Reithinger and Coleman, 2007;Vanlerberghe et al, 2007;Bacon et al, 2013;Lee et al, 2012b). Of the two vaccine studies, one focussed on visceral and the other on cutaneous leishmaniasis.…”