Vaccine coverage and the cost effectiveness of dengue vaccine in South East Asia

Background: Dengue is one of the most important vector-borne diseases, nearly 400000 reported cases in South East Asia and more than 2000 fatalities annually. The first of dengue vaccine called Dengvaxia by the French company, Sanofi Pasteur, was recently approved in Mexico, Brazil and the Philippines to be used for persons who are 9-45 years of age. Objective: The objective of this study was to estimate the effective of a vaccine to dengue transmission and the cost-effectiveness of the vaccine in South East Asia (SEA). Methods: : The simulation and analysis was carried out using a mathematical model for dengue transmission. The vaccine was given to a certain part of population in the community and the number of dengue infections and incidences was then calculated. The cost effective price of the vaccine was measured as disability adjusted life years (DALYs) averted, and the incremental cost-effectiveness ratio (ICER) of the vaccination was expressed in 2015 US dollars per DALY averted for the countries in SEA. Results: : The herd immunity was observed in the model simulation. The number of dengue incidences was declined with increased vaccine coverage in the community. If a vaccination program would be implemented the highly cost effective of vaccine per person should be 25-28 US dollars in SEA country on the average. Conclusions: : Our results describe effects of the dengue vaccination to infections and incidences. The price of the vaccine has been calculated and and it is different in each SEA country due to several factors such as the number of incidences, the GDP per capita, the hospital costs and the DALYs.