ABSTRACT
Objective: This study aims to estimate the incremental cost effectiveness of a supplementary immunization activity (SIA) for measles in a district of India with measles vaccine coverage equivalent to the National average. Design: A state transition model is used to estimate the effect of routine vaccination with measles vaccine as well as with measles vaccine during the SIA. The model follows each sub-cohort in the target population at respective age (1-5 years) to five years of age, using age specific incidence rate and vaccination rate to determine the number of cases of measles. Using age specific incidence rates and complication rates for measles; deaths and disability adjusted life year (DALY) averted is estimated. Results: Using base-case assumptions, an estimated 65479 cases of measles and 1637 deaths due to measles will be prevented in a span of four years from a single supplementary immunization activity in a pediatric population (1-5 years of age) of size 839,473. The cost per measles vaccine dose delivered is INR 30. Using base case analysis the cost to avert a death is INR 15381 and the cost per disability adjusted life year (DALY) averted is INR 430. Conclusions: Supplementary immunization activity for measles is cost-effective. However, this cannot be considered superior to a second dose of measles in routine immunization.
Subject(s)
Child, Preschool , Cohort Studies , Cost-Benefit Analysis , Decision Trees , Humans , Immunization, Secondary/economics , India , Infant , Measles/economics , Measles/prevention & control , Measles Vaccine/economicsABSTRACT
O presente estudo se propöe a analisar os casos de sarampo na regiäo de Londrina-PR, bem como verificar os custos de um paciente internado e os custos da vacina nas redes pública e particular. Os dados foram coletados junto ao Hospital Universitário Regional do Norte do Paraná, Secretaria Estadual de Saúde da Fundaçäo Caetano Munhoz da Rocha e a uma clínica particular, em janeiro de 1989. Concluiu-se que o sarampo continua sendo uma doença endêmica na regiäo estudada, sendo que 11,9 por cento de todos os casos necessitaram de internaçäo hospitalar. Observou-se também que, com o custo de uma hospitalizaçäo, num período de seis dias, seria possível imunizar 3144 crianças na rede pública e 94 crianças na rede particular.