Cost benefit study with Vi vaccine

Abstract

Typhoid fever is an acute generalized infection of the reticuloendothelial system, intestinal lymphoid tissue, and gall bladder caused by Salmonella typhi. The incidence of the disease is estimated in Indonesia at between 0.5 to 1% of the population. Although there are a number of antibiotics available to treat the disorder, the multi-resistant effects of antibiotics can delay effective treatment and increase the number of complications, mortality rate and the treatment cost. Typhoid fever vaccine is underused. However, an ex-ante economic appraisal of the expected consequences of its introduction in the prevention of typhoid fever may be valuable. This would provide decision makers with information to complete standard clinical data. The aim of this study is to evaluate, in economic terms, the typhoid fever vaccine in comparison with standard treatment for typhoid fever in four geographic distinct mining work sites. The population included both workers and their households. Using administrative records of healthcare services from an Indonesian HMO, we performed a simulation of the expected economic repercussions of vaccines on direct cost related to disease management (treatment) and indirect cost related to lost days'work (absenteeism). The results show that the standard treatment would cost 5,498,776 rupiah to treat 22 patients, or 249,944 rupiah per patient. Whereas, a vaccination program would cost 2,127,740 rupiah to vaccinate 260 people when the annual risk of contracting the disease is 23 percent and incidence of the disease is 0.0846. The company's net benefit would be 3,371,036 rupiah. The cost-benefit ratio would be 1:1.58; in brief terms, the company would save 1.58 rupiah for every 1 rupiah spent on the program. This study show that typhoid fever vaccine can save cost in the patient's health management of typhoid fever in a working environment. This can suggest that preventive treatment of typhoid fever with typhoid vaccine can provide cost savings in other environments.