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TP 116 Exploring the Cost-Effectiveness of a Hypothetical Chlamydia Vaccine for Young Females

Tuesday, June 10, 2014
Exhibit Hall
Kwame Owusu-Edusei Jr., PhD1, Harrell Chesson, PhD2, Thomas Gift, PhD3, Mark Gilbert, MD, MHSc, FRCPC4, Robert Brunham, MD5 and Gail Bolan, MD3, 1Division of STD Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA, 2Division STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 3Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 4Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada, 5British Columbia Centre for Disease Control, BC, Canada

Background:  In spite of existing chlamydia screening and treatment programs in most developed countries, the high burden of chlamydia persists, especially among the youth (15-24-year-olds). Although there is currently no chlamydia vaccine, future development of an effective chlamydia vaccine is possible. In this study, we explore the potential cost-effectiveness of a hypothetical chlamydia vaccine for young females in the United States (US) and British Columbia (BC), Canada.

Methods:  We constructed a simple heterosexual deterministic compartmental transmission model. Parameter values were obtained from the literature. The strategies we assessed included vaccination of 14-year-olds and catch-up vaccination for 15-24-year-old females in the context of an existing chlamydia screening program. For our base case, we assumed 30% annual screening coverage, 30% vaccine coverage, 75% vaccine efficacy, 10-year duration of vaccine-conferred immunity and $500 vaccine cost. We analyzed costs and benefits over a 50-year period and calculated the incremental cost-effectiveness ratio (ICER) of adding a chlamydia vaccination program to an existing chlamydia screening program. We also examine which model parameters had the most impact on the ICERs.

Results:  In the base case, the estimated ICERs of vaccinating 14-year-olds were $32,244/QALY (US) and $14,829/QALY (BC) when compared to screening only. Extending the program by including catch-up vaccination for 15-24-year-olds (US) and 15-35-year-olds (BC) resulted in an estimated ICER of $48,564/QALY (US) and $24,074/QALY (BC). When we assumed a vaccine with perfect performance (i.e., 100% efficacy and lifelong duration of efficacy), the ICERs were reduced by more than half; vaccinating only 14-year-olds was cost-saving in the BC analyses. The estimated ICER was most sensitive to pre-vaccination chlamydia prevalence followed by the cost of vaccination, the duration of vaccine-conferred immunity and vaccine efficacy.

Conclusions:  Our results suggest that an effective chlamydia vaccine could be cost-effective, particularly in high morbidity areas.

See more of: Poster Discussion One: Measurement--Measuring and Using Metrics
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