Context: During the period 2010-2014, Costa Rica had the second highest incidence of dengue in the region of Central America, the Caribbean and Mexico, and such position was affected by the 2013 outbreak, with nearly 50,000 registered cases this fact, together with the investments carried out in the country for control and prevention, makes dengue a relevant concern for public health and the authorities Objectives: This study carries out a cost-effectiveness analysis of the dengue vaccine using the public information available from the Ministry of Health, the Social Security Fund, and the National Institute for Research and Education of Costa Rica for the period 2008-2015. Since the public health system coverage is larger than 80%, private health care costs are not considered. Methods: A dynamic, compartmental and deterministic, transmission model of the disease1 was used in data calibration and scenario projection for the period 2017-2026. Six different scenarios are analyzed, including no-vaccination (NV), i.e., the case in which the country continues with the present measures; the most ambitious vaccination scenario includes a routine vaccination at the age of 9 years and 16 catch-up cohorts (R9+16). Results: By using as a reference the WHO criterion for assessing health interventions -from the social perspective, considering indirect effect and underreporting- the maximum price per dose for the intervention to be cost-effective is estimated in U$73.9 for a routine vaccination in the nine year-old risk population (R9), U$80.5 for a vaccination in the nine to fifteen year-old population (R9+6). Additionally, when the health impact is analyzed in terms of reduction (%) of the total dengue cases by scenario, the results are the following: -23% (R9) and -38% (R9+6). Conclusions: These results show that implementing an immunization schedule could be an effective and efficient way to fight dengue.
Xirinachs, Y. (2016). Cost-Effective Analysis Of The Dengue Vaccine In Costa Rica. Value in Health, 19(7), A414–A415. https://doi.org/10.1016/j.jval.2016.09.394