Assessing the Potential Cost-Effectiveness of Microneedle Patches in Childhood Measles Vaccination Programs: The Case for Further Research and Development
Assessing the Potential Cost-Effectiveness of Microneedle Patches in Childhood Measles Vaccination Programs: The Case for Further Research and Development
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DOI：
10.1007/s40268-016-0144-x
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发表时间：
2016-12-01
期刊：
影响因子：
3
通讯作者：
Meltzer, Martin I.
中科院分区：
文献类型：
--
作者：
Adhikari, Bishwa B.;Goodson, James L.;Meltzer, Martin I.
目的目前可用的麻疹疫苗通过皮下注射施用，并且需要用稀释剂和冷链重构，这是资源密集型的并且具有维持挑战性。为了克服这些挑战并可能增加疫苗接种覆盖率，正在开发微针贴片来提供麻疹疫苗。本研究比较了在儿童麻疹疫苗接种计划中使用微针贴片与传统的针-针（皮下接种）疫苗接种的成本效益。方法建立一个简单的电子表格模型，计算使用微针贴片和针-针技术的疫苗接种成本。我们假设，与目前的疫苗相比，微针疫苗将具有更高的热稳定性，并且在现场使用时需要更便宜的冷链。我们使用的历史数据，麻疹疫苗接种率低的社区之间的麻疹发病率。结果微针疫苗接种的成本估计为0.95美元（范围0.71- 1.18美元）的第一剂，相比之下，1.65美元（范围1.24- 2.06美元）的第一剂皮下接种。在95%的疫苗接种覆盖率下，微针贴片疫苗接种估计为避免每个麻疹病例花费1.66美元（1.24美元至2.07美元），而避免的每起案件的估计费用为2.64美元（范围1.98- 3.30美元）。不过，贴片的成本效益取决于接种者的接受程度，以及贴片相对于现有传统疫苗输送方法的疫苗效力。这项研究强调，需要继续研究和开发这种疫苗提供方法，通过改善疫苗的获得和增加疫苗接种覆盖率来促进消除麻疹的努力。
Objective Currently available measles vaccines are administered by subcutaneous injections and require reconstitution with a diluent and a cold chain, which is resource intensive and challenging to maintain. To overcome these challenges and potentially increase vaccination coverage, microneedle patches are being developed to deliver the measles vaccine. This study compares the costeffectiveness of using microneedle patches with traditional vaccine delivery by syringe-and-needle (subcutaneous vaccination) in children's measles vaccination programs. Methods We built a simple spreadsheet model to compute the vaccination costs for using microneedle patch and syringe-and-needle technologies. We assumed that microneedle vaccines will be, compared with current vaccines, more heat stable and require less expensive cool chains when used in the field. We used historical data on the incidence of measles among communities with low measles vaccination rates.Results The cost of microneedle vaccination was estimated at US$ 0.95 (range US$ 0.71-US$ 1.18) for the first dose, compared with US$ 1.65 (range US$ 1.24-US$ 2.06) for the first dose delivered by subcutaneous vaccination. At 95 % vaccination coverage, microneedle patch vaccination was estimated to cost US$ 1.66 per measles case averted (range US$ 1.24-US$ 2.07) compared with an estimated cost of US$ 2.64 per case averted (range US$ 1.98-US$ 3.30) using subcutaneous vaccination.Conclusions Use of microneedle patches may reduce costs; however, the cost-effectiveness of patches would depend on the vaccine recipients' acceptability and vaccine effectiveness of the patches relative to the existing conventional vaccine-delivery method. This study emphasizes the need to continue research and development of this vaccine-delivery method that could boost measles elimination efforts through improved access to vaccines and increased vaccination coverage.