Abstract
Background: Haemophilus influenzae type b (Hib) meningitis is associated with high mortality and serious sequelae in children under 5 years of age. Vaccines which can prevent this infection are available.
Objective: To evaluate the costs and benefits of a 3-dose immunisation schedule in Manila, Philippines.
Perspective: Government and societal perspectives.
Design and participants: A cost-benefit analysis based on a birth cohort of 100 000 children. The state of health of the cohort with and without a Hib immunisation programme was modelled over a 5-year period. A survey of medical records of patients with Hib in Manila provided data on the extent and cost of sequelae following infection. Intervention: A 3-dose Hib vaccination programme given at ages 2, 3 and 4 months.
Results: The model predicted that vaccinating children against Hib meningitis would prevent 553 cases per year in a birth cohort of 100 000, at a cost of 56 200 Philippine pesos (PHP) [$US1605; 1998 exchange rate] per case (base case assumptions of 90% vaccine efficacy rate, 95 per 100 000 Hib incidence rate, 85% vaccination coverage). Results from the cost-benefit analyses indicated that the saving to the government would be around PHP39 million ($US1.11 million), and the saving to society would be PHP255 million ($US7.28 million).
Conclusion: There would be a positive economic benefit for the Philippine government and for the Filipino society if a Hib vaccination programme was introduced in Manila.
Similar content being viewed by others
References
Limcangco MR, Salole EG, Armour CL. Epidemiology of Haemophilus influenzae type bmeningitis in Manila, Philippines, 1994 to 1996. Pediatr Infect Dis J 2000; 19 (1): 7–11
Ferreccio C, Ortiz E, Astroza L, et al. A population-based retrospective assessment of the disease burden resulting from invasive Haemophilus influenzae in infants and young children in Santiago, Chile. Pediatr Infect Dis J 1990; 9 (7): 488–94
Bijlmer HA, van Alphen L, Greenwood BM, et al. The epidemiology of Haemophilus influenzae meningitis in children under five years of age in The Gambia, West Africa. J Infect Dis 1990; 161 (6): 1210–5
Gilsdorf JR. Bacterial meningitis in southwestern Alaska. Am J Epidemiol 1977; 106 (5): 388–91
Trollfors B, Claesson BA, Strangert K, et al. Haemophilus influenzae meningitis in Sweden 1981–1983. Arch Dis Child 1987; 62 (12): 1220–5
Tudor-Williams G, Frankland J, Isaac D, et al. Haemophilus influenzae type b conjugate vaccine trial in Oxford: implications for the United Kingdom. Arch Dis Child 1989; 64 (4): 520–4
Takala AK, Eskola J, Peltola H, et al. Epidemiology of invasive Haemophilus influenzae type b disease among children in Finland before vaccination with Haemophilus influenzae conjugate vaccine. Pediatr Infect Dis J 1989; 8 (5): 297–302
Hammond GW, Rutherford BE, Malazdrewicz R, et al. Haemophilus influenzae meningitis in Manitoba and the Keewatin District, NWT: potential for mass vaccination. CMAJ 1988; 139 (8): 743–7
Gilbert GL, Johnson PD, Clements DA. Clinical manifestations and outcome of Haemophilus influenzae type b disease. J Paediatr Child Health 1995; 31 (2): 99–104
Thomas DG. Outcome of paediatric bacterial meningitis 1979- 1989. Med J Aust 1992; 157 (8): 519–20
Campbell H, Carter H. Rational use of Haemophilus influenzae type b vaccine. Drugs 1993; 46 (3): 378–83
Hay JW, Daum RS. Cost-benefit analysis of Haemophilus influenzae type b prevention: conjugate vaccination at eighteen months of age. Pediatr Infect Dis J 1990; 9 (4): 246–52
Ginsberg GM, Kassis I, Dagan R. Cost benefit analysis of Haemophilus influenzae type b vaccination programme in Israel. J Epidemiol Community Health 1993; 47 (6): 485–90
Harris A, Hendrie D, Bowen C, et al. The burden of Haemophilus influenzae type b disease in Australia and an economic appraisal of the vaccine PRP-OMP. Med J Aust 1994; 160 (8): 483–8
Trollfors B. Cost-benefit analysis of general vaccination against Haemophilus influenzae type b in Sweden. Scand J Infect Dis 1994; 26 (5): 611–4
McIntyre P, Hall J, Leeder S. An economic analysis of alternatives for childhood immunisation against Haemophilus influenzae type b disease. Aust J Public Health 1994; 18 (4): 394–400
Hussey G, Hitchcock J, Shaaf H, et al. Epidemiology of invasive Haemophilus influenzae infections in Cape Town, South Africa. Ann Trop Paediatr 1994; 14: 97–103
Levine OS, Ortiz E, Contreras R, et al. Cost-benefit analysis for the use of Haemophilus influenzae type b conjugate vaccine in Santiago, Chile. Am J Epidemiol 1993; 137 (11): 1221–8
Midani S, Ayoub EM, Rathore MH. Cost-effectiveness of Haemophilus influenzae type b conjugate vaccine program in Florida. J Fla Med Assoc 1995; 82 (6): 401–2
Livartowski A, Boucher J, Detournay B, et al. Cost-effectiveness evaluation of vaccination against Haemophilus influenzae disease in France. Vaccine 1996; 14 (6): 495–500
Jimenez FJ, Guallar-Castillon P, Terres CR, et al. Cost-benefit analysis of Haemophilus influenzae type b vaccination in children in Spain. Pharmacoeconomics 1999; 15 (1): 75–83
Microsoft Corporation. Microsoft Excel version 5, 1996
Shapiro ED, Capobianco LA, Berg AT, et al. The immunogenicity of Haemophilus influenzae type b polysaccharide-Neisseria meningitidis Group B outer membrane protein vaccine in infants and young children. J Infect Dis 1989; 160 (6): 1064–7
Watemberg N, Dagan R, Arbelli Y, et al. Safety and immunogenicity of Haemophilus type b-tetanus protein conjugate vaccine mixed in the same syringe with diphtheria-tetanus-pertussis vaccine in young infants. Pediatr Infect Dis J 1991; 10 (10): 758–63
Eskola J, Olander RM, Hovi T, et al. Randomised trial of the effect of co-administration with acellular pertussis DTP vaccine on immunogenicity of Haemophilus influenzae type b conjugate vaccine. Lancet 1996; 348: 1688–92
Capeding MR, Sombrero LT, Paladin FJ, et al. Etiology of acute respiratory infection in Filipino children under five years. South Asian J Trop Med Pub Health 1994; 25 (4): 684–7
National Economic Development Authority. 1996 economic performance. Manila: National Economic Development Authority, Republic of the Philippines, 1997
Drummond MF, O’Brien B, Stoddart GL, et al. Cost analysis. In: Methods for the economic evaluation of health care programmes. 2nd ed. New York (NY): Oxford University Press, 1997: 52–95
Rice DP, Hodgson TA, Kopstein AN. The economic cost of illness: a replication and update. Health Care Financ Rev 1985; 7 (1): 61–80
Anonymous. Expanded Program on Immunization: immunization coverage in Metropolitan Manila. WHO Wkly Rec 1984; 63: 285–6
Department of Health (Republic of the Philippines). Field guide for National Immunization Day. Manila: UNICEF, 1994
Santosham M, Wolff M, Reid R, et al. The efficacy in Navajo infants of conjugate vaccine consisting of Haemophilus influenzae type b polysaccharide and Neisseria meningitidis outer-membrane protein complex. N Engl J Med 1991; 324 (25): 1767–72
Eskola J, Kayhty H, Takala AK, et al.A randomized, prospective field trial of conjugate vaccine in the protection of infants and young children against invasive Haemophilus influenzae type b disease. N Engl J Med 1990; 323 (20): 1381–7
Peltola H, Kilpi T, Anttila M. Rapid disappearance of Haemophilus influenzae type b meningitis with conjugate vaccines. Lancet 1992; 340: 592–4
Barbour ML, Booy R, Crook DWM, et al. Haemophilus influenzae type b carriage and immunity four years after receiving the Haemophilus influenzae oligosaccharide-CRM197 (HbOC) conjugate vaccine. Pediatr Infect Dis J 1993; 12 (6): 478–84
Starr J, Rogers T, Impallomeni M. Hospital-acquired Clostridium difficile diarrhoea and herd immunity. Lancet 1997; 349: 426–8
Takala AK, Eskola J, Leinonen M, et al. Reduction of oropharyngeal carriage of Haemophilus influenzae type b (Hib) in children immunised with a Hib conjugate vaccine. J Infect Dis 1991; 164 (5): 982–6
Decker MD, Edwards KM, Bradley R, et al. Comparative trial in infants to four conjugate Haemophilus influenzae type b vaccines. J Pediatr 1992; 120 (2 Pt 1): 184–9
Ferreccio C, Clemens J, Avendano A, et al. The clinical and immunologic response of Chilean infants to Haemophilus influenzae type b polysaccharide-tetanus protein conjugate vaccine coadministered in the same syringe with diphtheriatetanus toxoid-pertussis vaccine at two, four and six months of age. Pediatr Infect Dis J 1991; 10 (10): 764–71
Capeding MR, Nohynek H, Pascual LG, et al. The immunogenicity of three Haemophilus influenzae type b conjugate vaccines after a primary vaccination series in Philippine infants. Am J Trop Med Hyg 1996; 55 (5): 516–20
Lagos R, Horwitz I, Toro G, et al. Large scale, postlicensure, selective vaccination of Chilean infants with PRP-T conjugate vaccine: practicality and effectiveness in preventing invasive Haemophilus influenzae type b infections. Pediatr Infect Dis J 1996; 15 (3): 216–22
Booy R, Heath PT, Slack MPE, et al. Vaccine failures after primary immunisation with Haemophilus influenzae type-b conjugate vaccine without booster. Lancet 1997; 349: 1197–202
Drummond MF, O’Brian B, Stoddart GL, et al. Methods for the economic evaluation of health care programmes. 2nd ed. New York (NY): Oxford University Press, 1997
Solon O, Gamboa RM, Schwartz JB, et al. Health sector financing in the Philippines. Manila: Department of Health, 1992
Hay JW, Daum RS. Cost-benefit analysis of two strategies for prevention of Haemophilus influenzae type b infection. Pediatrics 1987; 80 (3): 319–29
Daum RS, Granoff DM. Lessons from evaluation of immunogenicity. In: Ellis R, Granoff DM, editor. Development and clinical use of Haemophilus influenzae b conjugate vaccines. New York (NY): Marcel Dekker Inc., 1994: 291
Tupasi TE, Lucero MG, Magdangal DM, et al. Etiology of acute lower respiratory tract infection in children from Alabang, Metro Manila. Rev Infect Dis 1990; 12 Suppl. 8: S929–39
Tupasi TE, de Leon L, Lupisan S, et al. Community-based studies of acute respiratory tract infections in young children. Rev Infect Dis 1990; 12: S940-S949
Department of Health (Republic of the Philippines). 1996 Operational Plan, Expanded Program on Immunization. Manila: Department of Health, 1996
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Limcangco, M.R.M.T., Armour, C.L., Salole, E.G. et al. Cost-Benefit Analysis of a Haemophilus Influenzae Type B Meningitis Prevention Programme in The Philippines. Pharmacoeconomics 19, 391–400 (2001). https://doi.org/10.2165/00019053-200119040-00006
Published:
Issue Date:
DOI: https://doi.org/10.2165/00019053-200119040-00006