How cost effective is universal varicella vaccination in developing countries? A case-study from Colombia.

OBJECTIVE

Varicella vaccination has not been introduced worldwide, especially in developing countries. The present study assesses the potential epidemiological and economic impact of one-dose and two-dose varicella vaccination schemes in Colombia, a south American upper middle-income country.

METHODS

A decision-tree based model was developed. Varicella cases were estimated based on previous reports of seropositivity within the country. Cost per life-year gained (LYG) was the main outcome measure. Costs from the health care system perspective were expressed in 2008 American dollars. Deterministic and probabilistic sensitivity analyses were performed.

RESULTS

In Colombia, there would be 700,197 varicella cases in an average year plus 60 yearly deaths without vaccination. It was estimated that health care costs for all cases during 30 years period could be around US $88,734,735 (with discount). Cost per LYG of one-dose vaccination was US $2519 and using a two-dose scheme was US $5728.

CONCLUSION

Vaccinating against varicella in Colombia, an upper middle-income South American country is cost-effective under the assumptions used in this study. Decision-makers should consider introducing universal varicella vaccination in Colombia, given the effectiveness, safety and cost-effectiveness of this intervention.