Is Hib Vaccine of Economic Value in South Korea?

No abstract available.

Cost-Benefit Analysis of Haemophilus Influenzae Type B Immunization in Korea

An economic evaluation of Haemophilus influenzae type b (Hib) immunization was conducted to examine whether Hib immunization should be included in the Korea's national immunization program. The costs and benefits included direct and indirect values and an estimation of the economic efficiency. We determined that a universal Hib immunization program in Korea would prevent 17 deaths and 280 invasive Hib cases. When we assumed the one Hib immunization cost as 26,000 won, the national Hib immunization would cost 34.6 billion won. Costs for various Hib diseases were estimated at 26.8 billion won (11.8 billion won from direct costs and 14.9 billion won from indirect costs). A benefit-cost ratio of 0.77 showed that the economic efficiency of the integration of Hib immunization in Korea is low because of the low incidence rate of Hib disease and high price of vaccine. However, if the Hib immunization cost decrease to less than 20,000 won, a benefit-cost ratio increase to 1.0 and above, integrating Hib immunization into the national immunization program with economic efficiency can be considered.

Relación costo-efectividad de la vacuna contra Haemophilus influenzae tipo b en niños menores de dos años de edad en Colombia / The cost-effectiveness of Haemophilus influenzae type b vaccine for children under 2 years of age in Colombia

OBJETIVOS: Las vacunas conjugadas contra Haemophilus influenzae tipo b (Hib) son la herramienta más importante para prevenir la mayoría de las enfermedades invasoras producidas por dicho patógeno, pero debido a su costo, aún no se han introducido mundialmente de manera masiva. En el presente estudio se determinó la relación costo-efectividad de una vacuna contra Hib para prevenir la neumonía y la meningitis bacterianas en niños menores de 2 años en Colombia. MÉTODOS: Se estimaron los costos directos e indirectos de la neumonía y la meningitis hospitalaria y siguiendo las recomendaciones de la Organización Mundial de la Salud (OMS), la relación costo-efectividad de los programas de vacunación contra Hib. Se estimaron también las razones de costos por caso evitado de enfermedad invasora por Hib y el costo por año de vida salvado en dos situaciones hipotéticas: con vacunación contra Hib (cobertura vacunal: 90 por ciento) y sin vacunación. RESULTADOS: El costo medio del tratamiento hospitalario de un caso de neumonía fue de 611,5 dólares estadounidenses (US$) (intervalo de confianza del 95 por ciento [IC95 por ciento]: 532,2 - 690,8), el costo medio del tratamiento hospitalario de un caso de meningitis fue de US$ 848,9 (IC95 por ciento: 716,8 - 981,0) y el costo por caso evitado de enfermedad invasora por Hib, de US$ 316,7 (IC95 por ciento: 294,2 - 339,2). La relación costo-efectividad en la hipótesis con vacunación fue de 2,38, frente a 3,81 en la hipótesis sin vacunación. CONCLUSION: La aplicación de un programa adecuado de vacunación contra Hib en Colombia puede prevenir cerca de 25 000 casos de enfermedad invasora por año, lo que representa un ahorro de por lo menos US$ 15 millones anuales. Además, puede evitar cerca de 700 defunciones y salvar anualmente 44 054 años de vida.

OBJECTIVE: Conjugate vaccines are the best public health tools available for preventing most invasive diseases caused by Haemophilus influenzae type b (Hib), but the high cost of the vaccines has so far kept them from being introduced worldwide. The objective of this study was to estimate the cost-effectiveness of introducing Hib conjugate vaccines for the prevention of meningitis and pneumonia among children under 2 years of age in Colombia. METHODS: We estimated the direct and indirect costs of managing in-hospital pneumonia and meningitis cases. In addition, following the recommendations of the World Health Organization, we assessed the cost-effectiveness of Hib vaccination programs. We also estimated the costs for preventing Hib cases, and the cost per year of life saved in two hypothetical situations: (1) with vaccination against Hib (with 90 percent coverage) and (2) without vaccination. RESULTS: The average in-hospital treatment costs were US$ 611.50 (95 percent confidence interval (95 percent CI) = US$ 532.2 to US$ 690.8) per case of pneumonia and US$ 848.9 (95 percent CI = US$ 716.8 to US$ 981.0) per case of meningitis. The average cost per Hib case prevented was US$ 316.7 (95 percent CI = US$ 294.2 to US$ 339.2). In terms of cost-effectiveness, the cost would be US$ 2.38 per year of life saved for vaccination, versus US$ 3.81 per year of life saved without vaccination. CONCLUSION: Having an adequate Hib vaccination program in Colombia could prevent around 25 000 cases of invasive disease per year, representing a cost savings of at least US$ 15 million annually. Furthermore, the program could prevent some 700 deaths per year and save 44 054 years of life per year.

H. influenzae type b (Hib) vaccine--controversies.

Hib vaccine is the 8th vaccine knocking at the door to be included in the EPI the world over. However there are some controversies that need to be addressed, especially when it comes to use of this vaccine in India. It is difficult to culture Hib unless one uses sheep blood enriched media for culture. There is a lack of good community based data on Hib burden in India. This makes many feel that Hib is rare in India. However this is not true. There are many studies that have looked at this closely. Hib is a common cause of meningitis and pneumonitis in children less than 5 years old in India. There is wide spread problem of multi-drug resistance by Hib in India. Mortality of meningitis is as high as 100% if third generation cephalosporins are not used in time. Of the survivors of meningitis, 60% develop long-term sequelae. Hib vaccine is very effective and can lead to 99% reduction with mass vaccination in just 2-3 years. It is also a very safe vaccine. Of the conjugated vaccines available in India all are equally effective and safe and there is nothing to choose one over the other. There is a need to give a booster dose at 15-18 months of age. Even UK, which never gave the booster dose, is seriously thinking of changing their practice and give a booster dose. Lastly the combination vaccines of Hib with IPV, DPwT/DPaT, and Hepatitis B are safe and effective and should be encouraged to improve the compliance. The use of Hib vaccine is recommended in India, for those who can afford the vaccine.