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

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

Abstract

Despite the fact that the incidence and mortality rates due to dengue virus (DENV) infection in Indonesia are relatively high, dengue vaccination has not yet been introduced. This study aimed to analyse the cost-effectiveness and the budget impact of dengue vaccination in Indonesia by taking the potential of pre-vaccination screening into account. An age-structured decision tree model was developed to assess the cost-effectiveness value by applying a single cohort of 4,710,100 children that was followed-up in a 10-year time horizon within a 1-year analytical cycle. The budget impact was analysed in a 5-year period (2020–2024) by considering provinces’ readiness to introduce dengue vaccine and their incidence rate of DENV infection in the last 10 years. Vaccination that was coupled with pre-vaccination screening would reduce dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) by 188,142, 148,089 and 426 cases, respectively. It would save treatment cost at $23,433,695 and $14,091,642 from the healthcare and payer perspective, respectively. The incremental cost-effectiveness ratios (ICERs) would be $5,733 and $5,791 per quality-adjusted-life-year (QALY) gained from both perspectives. The most influential parameters affecting the ICERs were probability of DENV infection, vaccine efficacy, under-reporting factor, vaccine price, case fatality rate and screening cost. It can be concluded that dengue vaccination and pre-vaccination screening would be cost-effective to be implemented in Indonesia. Nevertheless, it seems unaffordable to be implemented since the total required cost for the nationwide vaccination would be 94.44% of routine immunization budget.Author summary: Up to now, dengue vaccination has not yet been included into the national immunization program in Indonesia. An age-structured decision tree model was developed in this study to assess the cost-effectiveness and the budget impact of dengue vaccination in Indonesia in 2020–2024, which was based on country specific data. The result confirmed that vaccination and pre-vaccination screening programs would be cost-effective to be implemented in Indonesia. Nevertheless, it seems unaffordable to be implemented since the total required cost for the nationwide vaccination would be 94.44% of routine immunization budget.

Suggested Citation

  • Auliya Abdurrohim Suwantika & Woro Supadmi & Mohammad Ali & Rizky Abdulah, 2021. "Cost-effectiveness and budget impact analyses of dengue vaccination in Indonesia," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 15(8), pages 1-16, August.
    • Handle: RePEc:plo:pntd00:0009664
    DOI: 10.1371/journal.pntd.0009664
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    References listed on IDEAS

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    1. Mardiati Nadjib & Ery Setiawan & Septiara Putri & Joshua Nealon & Sophie Beucher & Sri Rezeki Hadinegoro & Vetty Yulianty Permanasari & Kurnia Sari & Tri Yunis Miko Wahyono & Erna Kristin & Dewa Nyoma, 2019. "Economic burden of dengue in Indonesia," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 13(1), pages 1-14, January.
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    1. Abidemi, Afeez & Ackora-Prah, Joseph & Fatoyinbo, Hammed Olawale & Asamoah, Joshua Kiddy K., 2022. "Lyapunov stability analysis and optimization measures for a dengue disease transmission model," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 602(C).

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