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Cost-effectiveness of maternal influenza immunization in Bamako, Mali: A decision analysis
- Source :
- PLoS ONE, PLoS ONE, Vol 12, Iss 2, p e0171499 (2017)
- Publication Year :
- 2017
- Publisher :
- Public Library of Science (PLoS), 2017.
-
Abstract
- Background Maternal influenza immunization has gained traction as a strategy to diminish maternal and neonatal mortality. However, efforts to vaccinate pregnant women against influenza in developing countries will require substantial investment. We present cost-effectiveness estimates of maternal influenza immunization based on clinical trial data from Bamako, Mali. Methods We parameterized a decision-tree model using prospectively collected trial data on influenza incidence, vaccine efficacy, and direct and indirect influenza-related healthcare expenditures. Since clinical trial participants likely had better access to care than the general Malian population, we also simulated scenarios with poor access to care, including decreased healthcare resource utilization and worse influenza-related outcomes. Results Under base-case assumptions, a maternal influenza immunization program in Mali would cost $857 (95% UI: $188-$2358) per disability-adjusted life year (DALY) saved. Adjusting for poor access to care yielded a cost-effectiveness ratio of $486 (95% UI: $105-$1425) per DALY saved. Cost-effectiveness ratios were most sensitive to changes in the cost of a maternal vaccination program and to the proportion of laboratory-confirmed influenza among infants warranting hospitalization. Mean cost-effectiveness estimates fell below Mali’s GDP per capita when the cost per pregnant woman vaccinated was $1.00 or less with no adjustment for access to care or $1.67 for those with poor access to care. Healthcare expenditures for lab-confirmed influenza were not significantly different than the cost of influenza-like illness. Conclusions Maternal influenza immunization in Mali would be cost-effective in most settings if vaccine can be obtained, managed, and administered for ≤$1.00 per pregnant woman.
- Subjects :
- Viral Diseases
Economics
Cost effectiveness
Cost-Benefit Analysis
Maternal Health
lcsh:Medicine
Social Sciences
Mali
Geographical Locations
Families
0302 clinical medicine
Pregnancy
Outpatients
Health care
Medicine and Health Sciences
Per capita
Public and Occupational Health
030212 general & internal medicine
lcsh:Science
Children
Vaccines
education.field_of_study
030219 obstetrics & reproductive medicine
Multidisciplinary
Vaccination
Obstetrics and Gynecology
Cost-effectiveness analysis
Vaccination and Immunization
Infectious Diseases
Influenza Vaccines
Maternal Exposure
Female
Infants
Research Article
medicine.medical_specialty
Patients
Immunology
Cost-Effectiveness Analysis
Population
Developing country
Decision Support Techniques
03 medical and health sciences
Environmental health
Influenza, Human
medicine
Humans
education
Immunization Programs
business.industry
lcsh:R
Biology and Life Sciences
Vaccine efficacy
Influenza
Economic Analysis
Surgery
Health Care
Age Groups
People and Places
Africa
Women's Health
lcsh:Q
Population Groupings
Preventive Medicine
business
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....810859c1d22323170639e602b344f393