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Potential cost-effectiveness of a maternal Group B streptococcal vaccine in The Gambia.

Ahmed, N., Giorgakoudi, K. ORCID: 0000-0002-5925-1846, Usuf, E., Okomo, U., Clarke, E., Kampmann, B., Le Doare, K. and Trotter, C. (2020). Potential cost-effectiveness of a maternal Group B streptococcal vaccine in The Gambia.. Vaccine, 38(15), pp. 3096-3104. doi: 10.1016/j.vaccine.2020.02.071

Abstract

OBJECTIVE: To estimate neonatal health benefits and healthcare provider costs of a theoretical Group B streptococcal (GBS) hexavalent maternal vaccination programme in The Gambia, a low-income setting in West Africa. METHODS: A static decision analytic cost-effectiveness model was developed from the healthcare provider perspective. Demographic data and acute care costs were available from studies in The Gambia undertaken in 2012-2015. Further model parameters were taken from United Nations and World Health Organisation sources, supplemented by data from a global systematic review of GBS and literature searches. As vaccine efficacy is not known, we simulated vaccine efficacy estimates of 50-90%. Costs are reported in US dollars. Cost-effectiveness thresholds of one (US$473, very cost effective) and three (US$1420, cost effective) times Gambian GDP were used. RESULTS: Vaccination with a hexavalent vaccine would avert 24 GBS disease cases (55%) and 768 disability adjusted life years compared to current standard of care (no interventions to prevent GBS disease). At vaccine efficacy of 70%, the programme is cost-effective at a maximum vaccine price per dose of 12 US$ (2016 US$), and very cost-effective at a maximum of $3/dose. The total costs of vaccination at $12 is $1,056,962 for one annual cohort of Gambian pregnant women. One-way sensitivity analysis showed that GBS incidence was the most influential parameter on the cost effectiveness ratio. CONCLUSION: The introduction of a hexavalent vaccine would considerably reduce the current burden of GBS disease in The Gambia but to be cost-effective, the vaccine price per dose would need to be $12/dose or less.

Publication Type: Article
Additional Information: © 2020 Published by Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords: Cost-effectiveness, Vaccine Group B streptococcus, Streptococcus agalactiae, Neonatal infection
Subjects: R Medicine
R Medicine > RG Gynecology and obstetrics
R Medicine > RS Pharmacy and materia medica
Departments: School of Health Sciences > Healthcare Services Research & Management
URI: https://openaccess.city.ac.uk/id/eprint/23935
[img] Text - Accepted Version
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