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Peer reviewedOpen accessDengue

Cost-effectiveness and budget impact analyses of dengue vaccination in Indonesia

PLOS Neglected Tropical Diseases·

Auliya Abdurrohim Suwantika, Woro Supadmi, Mohammad Ali, Rizky Abdulah

DOI
10.1371/journal.pntd.0009664
PMID
34383764
PMCID
PMC8384188
OpenAlex
W3189548656
Study type
Commentary
Publisher
Public Library of Science (PLoS)
Article type
journal-article
Integrity
current

Why this research matters now

The study addresses dengue vaccination policy in a high-burden setting where dengue vaccination has not yet been introduced despite relatively high incidence and mortality rates.

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Structured evidence summary

Research question

The study evaluated the cost-effectiveness and budget impact of introducing dengue vaccination with pre-vaccination screening in Indonesia.

Study design

An age-structured decision tree model assessed cost-effectiveness for a single cohort of 4,710,100 children over a 10-year horizon with 1-year analytical cycles. Budget impact was analyzed over 5 years (2020-2024) considering provincial readiness and historical incidence rates.

Population and setting

The analysis focused on a birth cohort of children in Indonesia, with provincial stratification based on readiness to introduce dengue vaccine and 10-year incidence patterns.

Main findings

Vaccination with pre-vaccination screening would prevent 188,142 dengue fever cases, 148,089 dengue hemorrhagic fever cases, and 426 dengue shock syndrome cases. Incremental cost-effectiveness ratios were $5,733 per QALY gained (healthcare perspective) and $5,791 per QALY gained (payer perspective). The intervention would save $23.4 million in treatment costs from the healthcare perspective. However, nationwide implementation would consume 94.44% of the routine immunization budget, raising affordability concerns.

Public-health relevance

The study addresses dengue vaccination policy in a high-burden setting where dengue vaccination has not yet been introduced despite relatively high incidence and mortality rates.

Important limitations

This summary relies on the supplied single-article abstract and metadata. The decision tree model's assumptions, data sources for key parameters, sensitivity analysis scope beyond the six listed influential parameters, and generalizability across Indonesian provinces with varying epidemiological and healthcare contexts require examination of the original paper for decision-grade interpretation.

GIDS interpretation

This article is discoverable through disease (Dengue), geographic (Indonesia), and intervention (Vaccination, Vaccine effectiveness, Treatment) classifiers. The cost-effectiveness and budget impact findings provide context for policy decisions regarding dengue vaccine introduction in endemic settings where affordability constraints may influence implementation strategies.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 12 auditable classifier relationships to diseases, places, topics, and study design.

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