Revista Panamericana de Salud Pública
On-line version ISSN 1680-5348
Print version ISSN 1020-4989
ALVIS, Nelson; DE LA HOZ, Fernando and NARVAEZ, Javier. Economic impact of introducing the injectable inactivated polio vaccine in Colombia. Rev Panam Salud Publica [online]. 2010, vol.27, n.5, pp.352-359. ISSN 1680-5348. http://dx.doi.org/10.1590/S1020-49892010000500005.
OBJECTIVE: Evaluate the cost-effectiveness of introducing the injectable inactivated polio vaccine (IPV) in Colombia versus the current system based on the use of the oral vaccine (OPV). METHODS: A Markov model was designed, based on a hypothetical cohort of newborns that would receive the IPV or the OPV vaccine, with a two-year follow-up and monthly estimates of the number of cases of vaccine-associated paralytic poliomyelitis (VAPP) that would emerge. The cost was analyzed from the perspective of the insurer (costs throughout life) and society (cases of VAPP and disability-adjusted life years [DALYs] prevented). RESULTS: From 1988 to 1998, some 22.5 million doses of OVP were administered in Colombia and nine cases of VAPP were detected, for a rate of 4.0 ¥ 10-7 dose. According to the model, 2 to 4 cases of VAPP could be anticipated in the following two years. The cost of treating the VAPP cases would total US$302 008, with the cost of vaccination with OPV coming to US$737 037 and with IPV, US$5 527 777. Vaccination with IPV would prevent 64 DALYs, at a cost of US$71 062 per DALY prevented; preventing one case of VAPP by substituting OPV with IPV would cost between US$1.8 and US$2.2 million. CONCLUSIONS: Substituting OPV with IPV is not a cost-effective measure in Colombia, even if the cellular vaccine against whooping cough currently in use were replaced with an acellular vaccine combined with an IPV.
Keywords : Poliovirus vaccine, oral; poliovirus vaccine, inactivated; cost-benefit analysis; disability-adjusted life years; mass vaccination; Colombia.