ArticleVaccine2025
Microarray patch vaccines for typhoid conjugate vaccines: A global cost-effectiveness analysis.
Article in Vaccine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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5 authors.
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Abstract
A novel typhoid conjugate vaccine (TCV) presentation, the microarray patch (MAP), is in early-stage development and could potentially help to increase coverage in hard-to-reach populations beyond what is being achieved with the current TCV in a vial presentation administered with a needle and syringe (TCV-N&S). However, TCV-MAPs may come at a higher price per dose than TCV-N&S. Our analysis evaluated the potential cost-effectiveness of TCV-MAPs alongside TCV-N&S compared to TCV-N&S alone. A global extended cost-effectiveness analysis, taking a health care perspective, was conducted for 133 low- to upper-middle-income countries for a time horizon of 20 years (2033-2052). Health outcomes were expressed in disability-adjusted life years (DALYs) and costs in 2021 US dollars, both discounted at 3 %. We assumed TCV-MAP would cost 1.33 to 3 times the price of the TCV-N&S vaccine. We calculated incremental cost-effectiveness ratios and evaluated them against various cost-effectiveness thresholds. For five selected countries, we conducted an additional subnational analysis to understand the potential value of a district-specific TCV-MAP implementation instead of a national rollout. Across the 133 low- to upper-middle-income countries, national rollout of TCV-MAPs could avert an additional 5.2 million cases, 47,000 deaths, and 2.4 million DALYs compared to TCV-N&S only, at an additional cost of US$3.5 billion over 20 years. The largest proportion of the averted burden would be in the sub-Saharan African region. TCV-MAPs could be cost-effective in 33 % of the countries but in 78 % of sub-Saharan African countries. A subnational implementation could benefit some countries for which a national implementation may not be cost-effective, averting 2-15 % of cases for less than 1-3 % of the additional cost as compared to a national rollout. MAP price was a key driver of the results. Regional or subnational implementation, coupled with a lower price point, could significantly improve the TCV-MAP value proposition.
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