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and monetary costs until a vaccine program is implemented, the annualized present value of the health care costs saved would be $34.2 million.

If a vaccine program for TB 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 $90 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 $35.9 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 a TB 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 −$3,000. 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 $9,500.

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

READING LIST

Brewer TF, Heymann SJ, Colditz GA, et al. Evaluation of Tuberculosis Control Policies Using Computer Simulation. JAMA 1996; 276:1898–1903.

Brown RE, Miller B, Taylor WR, et al. Health-Care Expenditure for Tuberculosis in the United States. Archives of Internal Medicine 1995; 155:1595–1600.


CDC. The Role of BCG Vaccine in the Prevention and Control of Tuberculosis in the United States. Morbidity and Mortality Weekly Report 1996; 45:1–18.

CDC. Tuberculosis Morbidity—United States, 1995. Morbidity and Mortality Weekly Report 1996; 45:365–370.


Haas DW, Des Prez RM. Mycobacterium Tuberculosis. In: Principles and Practice of Infectious Diseases. GL Mandell, JE Bennett, Dolin R eds. New York, NY: Churchill Livingstone, 1995, pp. 2213–2243.


Miller B, Castro KG. Sharpen Available Tools for Tuberculosis Control, but New Tools Needed for Elimination. JAMA 1996; 276:1916–1917.


Singh GK, Kochanek KD, MacDorman MF. Advance Report of Final Mortality Statistics, 1994. Monthly Vital Statistics Report 1996; 45.

Smith MHD, Starke JR, Marquis JR. Tuberculosis and Opportunistic Mycobacterial Infections. In: Textbook of Pediatric Infectious Diseases. RD Feigin and JD Cherry eds. Philadelphia, PA: WB Saunder Company, 1992, pp. 1321–1362.



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