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Vaccines for the 21st Century: A Tool for Decisionmaking (2000)
Institute of Medicine (IOM)

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. "Appendix 13: Insulin-Dependent Diabetes Mellitus." Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press, 2000.

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Vaccines for the 21st Century: A Tool for Decisionmaking

If a vaccine program for IDDM were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the health care costs saved would be $2.5 billion. Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the health care costs saved would be $550 million.

If a vaccine program for IDDM were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the program cost would be $45 million. Using committee assumptions of less-than-ideal efficacy and utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the program cost would be $25 million.

Using committee assumptions of time and costs until licensure, the fixed cost of vaccine development has been amortized and is $10.8 million for an IDDM vaccine.

If a vaccine program were implemented today and the vaccine were 100% efficacious and utilized by 100% of the target population, the annualized present value of the cost per QALY gained is -$14,500. A negative value represents a saving in costs in addition to a saving in QALYs. Using committee assumptions of less-than-ideal utilization and including time and monetary costs until a vaccine program is implemented, the annualized present value of the cost per QALY gained is -$13,500.

See Chapters 4 and 5 for details on the methods and assumptions used by the committee for the results reported.

READING LIST

DERI Mortality Study Group. International Analysis of Insulin-Dependent Diabetes Mellitus Mortality: A Preventable Mortality Perspective. American Journal of Epidemiology 1995; 142:612–618.


Gorham ED, Garland FC, Barrett-Connor E, et al. Incidence of Insulin-Dependent Diabetes Mellitus in Young Adults: Experience of 1,587,630 US Navy Enlisted Personnel. American Journal of Epidemiology 1993; 138:984–987.


Metcalfe MA, Baum JD. Incidence of Insulin-Dependent Diabetes in Children Aged Under 15 years in the British Isles During 1988. BMJ 1991; 302:443–447.

Mølbak AG, Christau B, Marner B, et al. Incidence of Insulin-Dependent Diabetes Mellitus in Age Groups Over 30 years in Denmark. Diabetic Medicine 1994; 11:650–655.


National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes Statistics [WWW document]. URL http://www.niddk.nih.gov/index.htm (accessed September 23, 1996).


Schoenle EJ, Molinari L, Bagot M, et al. Epidemiology of IDDM in Switzerland. Diabetes Care 1994; 17:955–960.

Page
238
Front Matter (R1-R12)
Executive Summary (1-10)
Introduction (11-16)
Progress in Vaccine Development (17-38)
Considerations of Candidate Vaccines (39-52)
Overview of Analytic Approach and Results (53-92)
Review of the Analytical Model (93-108)
Ethical Considerations and Caveats (109-122)
Observations (123-132)
References (133-142)
Appendix 1: Borrelia burgdorferi (143-148)
Appendix 2: Chlamydia (149-158)
Appendix 3: Coccidioides Immitis (159-164)
Appendix 4: Cytomegalovirus (165-172)
Appendix 5: Enterotoxigenic E. coli (173-176)
Appendix 6: Epstein-Barr Virus (177-180)
Appendix 7: Helicobacter pylori (181-188)
Appendix 8: Hepatitis C (189-194)
Appendix 9: Herpes Simplex Virus (195-206)
Appendix 10: Histoplasma capsulatum (207-212)
Appendix 11: Human Paillomavirus (213-222)
Appendix 12: Influenza A and B (223-232)
Appendix 13: Insulin-Dependent Diabetes Mellitus (233-238)
Appendix 14: Melanoma (239-244)
Appendix 15: Multiple Sclerosis (245-250)
Appendix 16: Mycobacterium tuberculosis (251-256)
Appendix 17: Neisseria gonnorrhea (257-266)
Appendix 18: Neisseria meningitidis (267-272)
Appendix 19: Parainfluenza Virus (273-278)
Appendix 20: Respiratory Syncytial Virus (279-284)
Appendix 21: Rheumatoid Arthritis (285-290)
Appendix 22: Rotavirus (291-294)
Appendix 23: Shigella (295-298)
Appendix 24: Streptococcus, Group A (299-304)
Appendix 25: Streptococcus, Group B (305-312)
Appendix 26: Streptococcus pneumoniae (313-322)
Appendix 27: Information on accessing Electronic Spreadsheets (323-324)
Appendix 28: Summary of Workshops (325-434)
Appendix 29: Questions Posed to Outside Experts and List of Responders (435-442)
Index (443-460)