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Table A23–1 Health Care Costs Associated with Shigella Infection

 

% of Cases

Cost per Unit

Units per Case

Form of Treatment

Acute diarrhea

25%

$10

2.0

oral rehydration therapy

 

75%

$50

1.0

physician a

75%

$50

1.0

medication b

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 $620,000.

If a vaccine program for Shigella 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 $1.2 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 program cost would be $550 million.

Using committee assumptions of time and costs until licensure, the fixed cost of vaccine development has been amortized and is $7.2 million for a Shigella vaccine.

If a vaccine program were implemented today and the vaccine was 100% efficacious and utilized by 100% of the target population, the annualized present value of the cost per QALY gained is $7 million. 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 million. If the vaccine were utilized by 90% of travelers (and no infants) the annualized present value of the cost per QALY gained is $11 million.

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

READING LIST

Ashkenazi S, Cleary TG. Shigella Infections. In: Textbook of Pediatric Infectious Diseases. RD Feigin and JD Cherry eds. Philadelphia, PA: WB Saunder Company, 1992, pp. 637–646.


CDC. Summary of Notifiable Diseases, United States 1994. Morbidity and Mortality Weekly Report 1994; 43:1–80.


DuPont HL. Shigella Species (Bacillary Dysentery). In: Principles and Practice of Infectious Diseases. GL Mandell, JE Bennett, Dolin R eds. New York, NY: Churchill Livingstone, 1995, pp. 2033–2039.



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