Vaccines-2013 - OMICS Group

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Vinod Mrithinjayam, J Vaccines Vaccin 2013, 4:5http://dx.doi.org/10.4172/2157-7560.S1.0163 rd International Conference onVaccines & VaccinationJuly 29-31, 2013 Embassy Suites Las Vegas, NV, USACost-effectiveness of an additional birth dose of hepatitis B vaccine to prevent perinataltransmission in medical setting in a developing country (Mozambique)Vinod MrithinjayamAccenture Management Consulting, IndiaThis study is the first to assess the cost-effectiveness of an additional birth dose of Hepatitis B (HBV) vaccine administered byprofessional birth attendants in medical settings in a sub-Saharan country (Mozambique). The WHO has recommended thebirth dose to prevent perinatal transmission of HBV.A Markov model was constructed to analyze the costs and effects associated with avoiding perinatal transmission of HBVthrough a birth dose vaccination in addition to the existing vaccination schedule in Mozambique. The comparator interventionis the existing vaccination schedule administered at 6-10-14 weeks. The analysis was conducted for the birth cohort of 2008. Asthe context is a low-income setting our main outcome measure was disability-adjusted life years (DALYs) averted. Transitionprobabilities, costs and effects were estimated based on a thorough literature review. One- to three-way sensitivity analyses wereconducted to account for uncertainty in the data.We found an incremental cost-effectiveness ratio (ICER) for the additional birth dose of 250.95 US$/DALY averted.Assuming a willingness-to-pay threshold of 441 US$, which was the GDP per capita for Mozambique in 2008, the findings showthe additional birth dose to be highly cost-effective. However, one-way sensitivity analysis reveals that the outcome changes withparameter variation. To give unambiguous recommendations on introducing the birth dose in Mozambique, more informationon the parameters that render the birth dose cost-ineffective in sensitivity analysis is needed. Those parameters are ‘vaccineeffectiveness’, ‘prevalence of HBV among mothers’, ‘the transition probability from chronic HBV to liver cancer’ and ‘the risk ofperinatal transmission for mothers negative for the Hepatitis B “e” antigen (HBeAg)’. Parameter variation (one-way) showed theICER to lie between 72 US$/DALY averted and 683 US$/DALY averted.BiographyVinod Mrithinjayam, currently a management consultant, graduated from department of health policy, The London School of Economics and PoliticalSciences in 2011. He is also a registered pharmacist in India and has over 6 years of experience delivering healthcare consulting projects. He hasworked with a diverse set of health insurers, medical devices & technology, and pharmaceutical companies across U.S and U.K. His core skillsare life sciences, healthcare IT, health economics, corporate strategy, and public policy & reforms. He is also a Professional Academy of HealthManagement Certifi ed from the United States.vinodsm85@gmail.comJ Vaccines Vaccin 2013ISSN: 2157-7560, JVV an open access journalVaccines-2013July 29-31, 2013Volume 4 Issue 5Page 90
Abdur Razzaque Sarker et al., J Vaccines Vaccin 2013, 4:5http://dx.doi.org/10.4172/2157-7560.S1.0163 rd International Conference onVaccines & VaccinationJuly 29-31, 2013 Embassy Suites Las Vegas, NV, USACost of illness for cholera in a high risk urban area in Bangladesh: An analysis from thehousehold perspectiveAbdur Razzaque Sarker, Ziaul Islam, Iqbal Ansary Khan, Amit Saha, Fahima Chowdhury, Ashraful Islam Khan, Firdausi Qadri andJahangir A. M. KhanInternational Centre for Diarrhoeal Disease Research, BangladeshBackground: Cholera poses a substantial health burden to developing countries like Bangladesh. In this study, the objective wasto estimate the economic burden of cholera treatment incurred by households. The study has been carried out in the context of alarge vaccine trial in an urban area of Bangladesh.Methods: The study used a combination of prospective and retrospective incidence-based cost analyses of cholera illness perepisode per household. A total of 400 cholera confirmed cases were identified and treated during June-October 2011 in urbanBangladesh. To estimate the total cost of cholera illness, a structured questionnaire was used, which included queries on directmedical cost non-medical cost and indirect cost of patients and caregivers.Findings: The average total cost of illness during an episode of cholera was estimated to cost 30.4 US$ per household per episode.Total direct and indirect costs constituted 24.4% (7.4 US$) and 75.6% (23.0 US$) of the average total cost respectively. The costfor children under 5 years of age (21 US$) was higher than that of children at age 5-14 years (18 US$). Otherwise, costs increasedwith age. Direct cost of treatment was similar for male and female patients, but the indirect cost was higher for the former.Conclusion: Among medical cost components, medicines are the largest cost driver. No clear socioeconomic gradient emergedfrom our study, but limited demographic patterns have been observed in cost of illness. By preventing cholera cases, a largemagnitude of production loss can be reduced.BiographyAbdur Razzaque Sarker completed his masters of health economics in University of Dhaka in Bangladesh. He currently work as a member of healtheconomist team at ICDDR in Bangladesh. He is the research investigator of various project like “Economic Evaluation of Introduction of CholeraVaccine in Bangladesh”, “Estimating Costs of Infant and Young Child-Feeding (IYCF) Practices Improvement Program in Bangladesh”, “EstimatingCosts of MNCH Initiative in Bangladesh Implemented by UNICEF”, “Healthy Youth Development and Resilience Study”, “Self-fi nanced healthscheme of labor cooperative for accessing quality healthcare of informal sector workers in Bangladesh” and others.razzaque.sarker@gmail.comJ Vaccines Vaccin 2013ISSN: 2157-7560, JVV an open access journalVaccines-2013July 29-31, 2013Volume 4 Issue 5Page 91
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