%0 Journal Article
%T The Potential Economic Value of a Trypanosoma cruzi (Chagas Disease) Vaccine in Latin America
%A Bruce Y. Lee
%A Kristina M. Bacon
%A Diana L. Connor
%A Alyssa M. Willig
%A Rachel R. Bailey
%J PLOS Neglected Tropical Diseases
%D 2010
%I Public Library of Science (PLoS)
%R 10.1371/journal.pntd.0000916
%X Background Chagas disease, caused by the parasite Trypanosoma cruzi (T. cruzi), is the leading etiology of non-ischemic heart disease worldwide, with Latin America bearing the majority of the burden. This substantial burden and the limitations of current interventions have motivated efforts to develop a vaccine against T. cruzi. Methodology/Principal Findings We constructed a decision analytic Markov computer simulation model to assess the potential economic value of a T. cruzi vaccine in Latin America from the societal perspective. Each simulation run calculated the incremental cost-effectiveness ratio (ICER), or the cost per disability-adjusted life year (DALY) avoided, of vaccination. Sensitivity analyses evaluated the impact of varying key model parameters such as vaccine cost (range: $0.50¨C$200), vaccine efficacy (range: 25%¨C75%), the cost of acute-phase drug treatment (range: $10¨C$150 to account for variations in acute-phase treatment regimens), and risk of infection (range: 1%¨C20%). Additional analyses determined the incremental cost of vaccinating an individual and the cost per averted congestive heart failure case. Vaccination was considered highly cost-effective when the ICER was ¡Ü1 times the GDP/capita, still cost-effective when the ICER was between 1 and 3 times the GDP/capita, and not cost-effective when the ICER was >3 times the GDP/capita. Our results showed vaccination to be very cost-effective and often economically dominant (i.e., saving costs as well providing health benefits) for a wide range of scenarios, e.g., even when risk of infection was as low as 1% and vaccine efficacy was as low as 25%. Vaccinating an individual could likely provide net cost savings that rise substantially as risk of infection or vaccine efficacy increase. Conclusions/Significance Results indicate that a T. cruzi vaccine could provide substantial economic benefit, depending on the cost of the vaccine, and support continued efforts to develop a human vaccine.
%U http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000916