ArticleBMC public health2011
Cost-effectiveness of novel vaccines for tuberculosis control: a decision analysis study.
Article in BMC public health, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of mathematical models exploring the epidemiological impact of future TB vaccines.Human vaccines & immunotherapeutics · 2016Pooled it
- Supply, demand and use of economic evidence in vaccine policymaking in Africa: A scoping review.PLOS global public health · 2026Article
- Bridging the gap: evaluating high TB burden country data needs to support the potential introduction of TB vaccines for adolescents and adults: a workshop report.Frontiers in tuberculosis · 2024Article
- Cost-effectiveness of routine adolescent vaccination with an M72/AS01Nature communications · 2022Article
- The epidemiologic impact and cost-effectiveness of new tuberculosis vaccines on multidrug-resistant tuberculosis in India and China.BMC medicine · 2021Article
- A review of clinical models for the evaluation of human TB vaccines.Human vaccines & immunotherapeutics · 2016Review
- TB vaccine development and the End TB Strategy: importance and current status.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2016Review
- Impact and cost-effectiveness of new tuberculosis vaccines in low- and middle-income countries.Proceedings of the National Academy of Sciences of the United States of America · 2014Article
- How can mathematical models advance tuberculosis control in high HIV prevalence settings?The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2014Review
- Modelling the cost-effectiveness of a new infant vaccine to prevent tuberculosis disease in children in South Africa.Cost effectiveness and resource allocation : C/E · 2014Article
- Article
- Identification of antigens specific to non-tuberculous mycobacteria: the Mce family of proteins as a target of T cell immune responses.PloS one · 2011Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe development of a successful new tuberculosis (TB) vaccine would circumvent many limitations of current diagnostic and treatment practices. However, vaccine development is complex and costly. We aimed to assess the potential cost effectiveness of novel vaccines for TB control in a sub-Saharan African country--Zambia--relative to the existing strategy of directly observed treatment, short course (DOTS) and current level of bacille Calmette-Guérin (BCG) vaccination coverage.
methodsWe conducted a decision analysis model-based simulation from the societal perspective, with a 3% discount rate and all costs expressed in 2007 US dollars. Health outcomes and costs were projected over a 30-year period, for persons born in Zambia (population 11,478,000 in 2005) in year 1. Initial development costs for single vaccination and prime-boost strategies were prorated to the Zambian share (0.398%) of global BCG vaccine coverage for newborns. Main outcome measures were TB-related morbidity, mortality, and costs over a range of potential scenarios for vaccine efficacy.
resultsRelative to the status quo strategy, a BCG replacement vaccine administered at birth, with 70% efficacy in preventing rapid progression to TB disease after initial infection, is estimated to avert 932 TB cases and 422 TB-related deaths (prevention of 199 cases/100,000 vaccinated, and 90 deaths/100,000 vaccinated). This would result in estimated net savings of $3.6 million over 30 years for 468,073 Zambians born in year 1 of the simulation. The addition of a booster at age 10 results in estimated savings of $5.6 million compared to the status quo, averting 1,863 TB cases and 1,011 TB-related deaths (prevention of 398 cases/100,000 vaccinated, and of 216 deaths/100,000 vaccinated). With vaccination at birth alone, net savings would be realized within 1 year, whereas the prime-boost strategy would require an additional 5 years to realize savings, reflecting a greater initial development cost.
conclusionsInvestment in an improved TB vaccine is predicted to result in considerable cost savings, as well as a reduction in TB morbidity and TB-related mortality, when added to existing control strategies. For a vaccine with waning efficacy, a prime-boost strategy is more cost-effective in the long term.
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