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Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore

Author

Listed:
  • Carrasco, Luis R
  • Lee, Linda K
  • Lee, Vernon J
  • Ooi, Eng Eong
  • Shepard, Donald S
  • Thein, Tun L
  • Gan, Victor
  • Cook, Alex R
  • Lye, David
  • Ng, Lee Ching
  • Leo, Yee Sin

Abstract

Background: Dengue illness causes 50–100 million infections worldwide and threatens 2.5 billion people in the tropical and subtropical regions. Little is known about the disease burden and economic impact of dengue in higher resourced countries or the cost-effectiveness of potential dengue vaccines in such settings. Methods and Findings: We estimate the direct and indirect costs of dengue from hospitalized and ambulatory cases in Singapore. We consider inter alia the impacts of dengue on the economy using the human-capital and the friction cost methods. Disease burden was estimated using disability-adjusted life years (DALYs) and the cost-effectiveness of a potential vaccine program was evaluated. The average economic impact of dengue illness in Singapore from 2000 to 2009 in constant 2010 US$ ranged between $0.85 billion and $1.15 billion, of which control costs constitute 42%–59%. Using empirically derived disability weights, we estimated an annual average disease burden of 9–14 DALYs per 100 000 habitants, making it comparable to diseases such as hepatitis B or syphilis. The proportion of symptomatic dengue cases detected by the national surveillance system was estimated to be low, and to decrease with age. Under population projections by the United Nations, the price per dose threshold for which vaccines stop being more cost-effective than the current vector control program ranged from $50 for mass vaccination requiring 3 doses and only conferring 10 years of immunity to $300 for vaccination requiring 2 doses and conferring lifetime immunity. The thresholds for these vaccine programs to not be cost-effective for Singapore were $100 and $500 per dose respectively. Conclusions: Dengue illness presents a serious economic and disease burden in Singapore. Dengue vaccines are expected to be cost-effective if reasonably low prices are adopted and will help to reduce the economic and disease burden of dengue in Singapore substantially.

Suggested Citation

  • Carrasco, Luis R & Lee, Linda K & Lee, Vernon J & Ooi, Eng Eong & Shepard, Donald S & Thein, Tun L & Gan, Victor & Cook, Alex R & Lye, David & Ng, Lee Ching & Leo, Yee Sin, 2011. "Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore," MPRA Paper 57761, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:57761
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    References listed on IDEAS

    as
    1. Keating, Joseph, 2001. "An investigation into the cyclical incidence of dengue fever," Social Science & Medicine, Elsevier, vol. 53(12), pages 1587-1597, December.
    2. Koopmanschap, Marc A. & Rutten, Frans F. H. & van Ineveld, B. Martin & van Roijen, Leona, 1995. "The friction cost method for measuring indirect costs of disease," Journal of Health Economics, Elsevier, vol. 14(2), pages 171-189, June.
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    Cited by:

    1. Le T P Nghiem & Tarek Soliman & Darren C J Yeo & Hugh T W Tan & Theodore A Evans & John D Mumford & Reuben P Keller & Richard H A Baker & Richard T Corlett & Luis R Carrasco, 2013. "Economic and Environmental Impacts of Harmful Non-Indigenous Species in Southeast Asia," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-9, August.
    2. Eunha Shim, 2017. "Cost-effectiveness of dengue vaccination in Yucatán, Mexico using a dynamic dengue transmission model," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-17, April.
    3. Eduardo A Undurraga & Yara A Halasa & Donald S Shepard, 2013. "Use of Expansion Factors to Estimate the Burden of Dengue in Southeast Asia: A Systematic Analysis," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 7(2), pages 1-15, February.
    4. Christopher Fitzpatrick & Alexander Haines & Mathieu Bangert & Andrew Farlow & Janet Hemingway & Raman Velayudhan, 2017. "An economic evaluation of vector control in the age of a dengue vaccine," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 11(8), pages 1-27, August.
    5. Nghiem, Le T.P. & Soliman, Tarek & Yeo, Darren C. J. & Tan, Hugh T. W. & Evans, Theodore A. & Mumford, John D. & Keller, Reuben P. & Baker, Richard H. A. & Corlett, Richard T. & Carrasco, Luis R., 2013. "Economic and Environmental Impacts of Harmful Non-Indigenous Species in Southeast Asia," MPRA Paper 57760, University Library of Munich, Germany.
    6. Dagna Constenla & Cristina Garcia & Noah Lefcourt, 2015. "Assessing the Economics of Dengue: Results from a Systematic Review of the Literature and Expert Survey," PharmacoEconomics, Springer, vol. 33(11), pages 1107-1135, November.
    7. Gerhart Knerer & Christine S M Currie & Sally C Brailsford, 2020. "The economic impact and cost-effectiveness of combined vector-control and dengue vaccination strategies in Thailand: results from a dynamic transmission model," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(10), pages 1-32, October.
    8. Donald S Shepard & Eduardo A Undurraga & Yara A Halasa, 2013. "Economic and Disease Burden of Dengue in Southeast Asia," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 7(2), pages 1-12, February.
    9. Ong, Suan Ee & Tyagi, Shilpa & Lim, Jane Mingjie & Chia, Kee Seng & Legido-Quigley, Helena, 2018. "Health systems reforms in Singapore: A qualitative study of key stakeholders," Health Policy, Elsevier, vol. 122(4), pages 431-443.
    10. May Ee Png & Joanne Su-Yin Yoong, 2014. "Evaluating the Cost-Effectiveness of Lifestyle Modification versus Metformin Therapy for the Prevention of Diabetes in Singapore," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-8, September.
    11. Gabueva, Larisa A. (Габуева, Лариса) & Pavlova, Nina F. (Павлова, Нина), 2017. "Foreign and Domestic Trends in the Development of Competition in Health Care: Recognition and Measurement of Professional Reputation [Зарубежные И Отечественные Тренды Развития Конкуренции В Здраво," Working Papers 021705, Russian Presidential Academy of National Economy and Public Administration.

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    More about this item

    Keywords

    Health Economics; Dengue Vaccines; Cost-Effective Analysis;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I19 - Health, Education, and Welfare - - Health - - - Other

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