Table A10–3 summarizes the health care costs incurred by histoplasma infections. For the purposes of the calculations in this report, it was assumed that all patients with flu-like illness associated with histoplasma infection require outpatient care of a physician and that half receive medications or diagnostics. All patients with pneumonitis were assumed to incur costs associated with specialist visits and diagnostics. Inpatient hospital costs are included for a small fraction of these patients. It was assumed that half of the patients with disseminated disease would require hospitalization. All patients with disseminated disease would require outpatient treatment lasting several months and including 8 visits to a specialist and expensive medication and diagnostic costs. Approximately 40% of patients with chronic pulmonary disease would require hospitalization and all of the patients would require outpatient treatment similar to that estimated for disseminated disease but for 3 times the duration and cost.
The committee assumed that it will take 15 years until licensure of a histoplasma vaccine and that $360 million needs to be invested. Table 4–1 summarizes vaccine development assumptions for all vaccines considered in this report.
For the purposes of the calculations in this report, it is assumed that the target population for this vaccine is all infants in endemic regions (approximately 900,000 annually) and migrants into the area (approximately 1,300,000 annually at an average age of 28.9 per migrant vaccinee). It was assumed that 90% of the infants born in the region and 10% of migrants would utilize the vaccine.
For the purposes of the calculations in this report, it was estimated that this vaccine would cost $50 per dose and that administration costs would be $10 per dose. Default assumptions of a 3-dose series and 75% effectiveness were accepted. Table 4–1 summarizes vaccine program assumptions for all vaccines considered in this report.