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Vaccines for the 21st Century A Tool for Decisionmaking (2000) / Chapter Skim
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Appendix 16: Mycobacterium tuberculosis
Pages 251-256

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From page 251...
... Miliary tuberculosis occurs when the tubercle bacilli gain access to the lymphatics and bloodstream and seed distant organs. Miliary lesions may develop in almost any organ of the body, but of the most favored sites are bones and joints, the genitourinary tract, meninges, lymph nodes, and peritoneum.
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From page 252...
... . Health care costs incurred for pulmonary and extrapulmonary TB are assumed to involve hospitalization followed by 9 months of outpatient treatment.
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From page 253...
... Table 4-1 summarizes vaccine development assumptions for all vaccines considered in this report. VACCINE PROGRAM CONSIDERATIONS Target Population For the purposes of the calculations in this report, it is assumed that the target population for this vaccine is 500,000 high-risk people.
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From page 254...
... Asymptomatic suspect suspect cases (treatment begun) Asymptomatic latent infection preventive treatment for latent infection Pulmonary TB inpatient Pulmonary TB outpatient Extrapulmonary TB inpatient Ex~apulmonary TB outpatient 22~795 68~385 1137975 300.00% 1.0000 500.00% 1.0000 20,060 88.00% 0.8700 19,057 2,735 0.2500 (3 months)
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From page 255...
... preventive treatment for latent 75% $25 6.0 nurse visit infection: 6 months estimated 60% complete treat- 100% $50 1.0 diagnostic a meet; rest complete half of treatment 60% $50 6.0 medication b: com pletes course 40% $50 3.0 medication b: com pletes half course Pulmonary TB inpatient 100% $6,000 1.0 hospitalization 100% $100 3.0 physician b 100% $50 1.0 diagnostic a 25% $500 1.0 diagnostic c Pulmonary TB outpatient 100% $50 9.0 physician a 100% $50 9.0 diagnostic a 100% $50 9.0 medication b Extrapulmonary TB inpatient 100% $6,000 1.0 hospitalization 100% $100 3.0 physician b 100% $50 1.0 diagnostic b 25% $500 1.0 diagnostic c Extrapulmonary TB outpatient 100% $50 9.0 physician a 100% $50 9.0 diagnostic a 100% $50 9.0 medication b 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 health care costs saved would be $100 million. Using committee assumptions of less-than-ideal efficacy and utilization and including time
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From page 256...
... 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.
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Key Terms

  • target population
  • care costs
  • committee assumptions
  • using committee
  • including time

  • monetary costs
  • primary infection
  • qalys gained
  • preventive treatment
  • committee assumed

  • qaly gained
  • latent infections
  • mortality weekly
  • miliary tuberculosis
  • costs saved

  • vaccine development
  • mycobacterium tuberculosis
  • program cost
  • summarizes vaccine
  • tuberculosis control

  • vaccines considered
  • weekly report
  • costs incurred
  • infection increases
  • treatment regime

  • infection result
  • insidious onset
  • physician visit
  • statistics report
  • treatment phase


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