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PREDICTING THE COST-EFFECTIVENESS OF INTRODUCING A PRE-ERYTHROCYTIC MALARIA VACCINE INTO THE EXPANDED PROGRAM ON IMMUNIZATION IN TANZANIA

We model the cost-effectiveness of the introduction of a pre-erythrocytic malaria vaccine into the Expanded Program on Immunization. We use a dynamic stochastic simulation model of the epidemiology of Plasmodium falciparum in malaria-endemic areas and of case management in Tanzania. We consider a range of vaccine characteristics and a range of transmission settings. At low vaccine prices, the cost-effectiveness of such vaccines may be similar to that of other established preventative and curative interventions against malaria. The cost-effectiveness ratio increases rapidly and approximately linearly with vaccine cost per dose. The approach can be adopted for comparative analyses of the cost effectiveness of different vaccines and other intervention strategies.

Received September 18, 2005. Accepted for publication April 9, 2006.

Acknowledgements: We thank the members of the Technical Advisory Group (Michael Alpers, Paul Coleman, David Evans, Brian Greenwood, Carol Levin, Kevin Marsh, F. Ellis McKenzie, Mark Miller, and Brian Sharp), the Project Management Team at the Program for Appropriate Technology in Health (PATH) Malaria Vaccine Initiative, and GlaxoSmithKline Biologicals S.A. for supporting this study.

Financial support: The mathematical modeling study was supported by the PATH Malaria Vaccine Initiative and GlaxoSmithKline Biologicals S.A.

Disclaimer: This publication and the contents hereof do not necessarily reflect the endorsement, opinion, or viewpoints of the PATH Malaria Vaccine Initiative or GlaxoSmithKline Biologicals S.A..

^* Address correspondence to Thomas A. Smith, Swiss Tropical Institute, Socinstrasse 57, Postfach, CH-4002 Basel, Switzerland. E-mail: Thomas-A.Smith{at}unibas.ch

Authors’ address: Fabrizio Tediosi, Guy Hutton, Nicolas Maire, Thomas A. Smith, Amanda Ross, and Marcel Tanner, Swiss Tropical Institute, Socinstrasse 57, Postfach, CH-4002 Basel, Switzerland, Telephone: 41-284-8273, Fax: 41-284-8105, E-mails: fabrizio.tediosi{at}unibas.ch, nicolas.maire{at}unibas.ch, Thomas-A.Smith{at}unibas.ch, amanda.ross{at}unibas.ch, guy.hutton{at}unibas.ch, and marcel.tanner{at}unibas.ch.

Reprint requests: Thomas A. Smith, Swiss Tropical Institute, Socinstrasse 57, Postfach, CH 4002 Basel, Switzerland.

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