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Retrospective Cost‐Effectiveness Analyses for Polio Vaccination in the United States

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  • Kimberly M. Thompson
  • Radboud J. Duintjer Tebbens

Abstract

The history of polio vaccination in the United States spans 50 years and includes different phases of the disease, multiple vaccines, and a sustained significant commitment of resources. We estimated cost‐effectiveness ratios and assessed the net benefits of polio vaccination applicable at various points in time from the societal perspective and we discounted these back to appropriate points in time. We reconstructed vaccine price data from available sources and used these to retrospectively estimate the total costs of the U.S. historical polio vaccination strategies (all costs reported in year 2002 dollars). We estimate that the United States invested approximately $35 billion (1955 net present value, discount rate of 3%) in polio vaccines between 1955 and 2005 and will invest approximately $1.4 billion (1955 net present value, or $6.3 billion in 2006 net present value) between 2006 and 2015 assuming a policy of continued use of inactivated poliovirus vaccine (IPV) for routine vaccination. The historical and future investments translate into over 1.7 billion vaccinations that prevent approximately 1.1 million cases of paralytic polio and over 160,000 deaths (1955 net present values of approximately 480,000 cases and 73,000 deaths). Due to treatment cost savings, the investment implies net benefits of approximately $180 billion (1955 net present value), even without incorporating the intangible costs of suffering and death and of averted fear. Retrospectively, the U.S. investment in polio vaccination represents a highly valuable, cost‐saving public health program. Observed changes in the cost‐effectiveness ratio estimates over time suggest the need for living economic models for interventions that appropriately change with time. This article also demonstrates that estimates of cost‐effectiveness ratios at any single time point may fail to adequately consider the context of the investment made to date and the importance of population and other dynamics, and shows the importance of dynamic modeling.

Suggested Citation

  • Kimberly M. Thompson & Radboud J. Duintjer Tebbens, 2006. "Retrospective Cost‐Effectiveness Analyses for Polio Vaccination in the United States," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1423-1440, December.
    • Handle: RePEc:wly:riskan:v:26:y:2006:i:6:p:1423-1440
    DOI: 10.1111/j.1539-6924.2006.00831.x
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    References listed on IDEAS

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    1. Nancy Thiry & Philippe Beutels & Pierre Damme & Eddy Doorslaer, 2003. "Economic Evaluations of Varicella Vaccination Programmes," PharmacoEconomics, Springer, vol. 21(1), pages 13-38, January.
    2. Radboud J. Duintjer Tebbens & Mark A. Pallansch & Olen M. Kew & Victor M. Cáceres & Hamid Jafari & Stephen L. Cochi & Roland W. Sutter & R. Bruce Aylward & Kimberly M. Thompson, 2006. "Risks of Paralytic Disease Due to Wild or Vaccine‐Derived Poliovirus After Eradication," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1471-1505, December.
    3. Hinman, A.R. & Koplan, J.P. & Orenstein, W.A. & Brink, E.W. & Nkowane, B.M., 1988. "Live or inactivated poliomyelitis vaccine: An analysis of benefits and risks," American Journal of Public Health, American Public Health Association, vol. 78(3), pages 291-295.
    4. Philippe Beutels, 2001. "Economic evaluations of hepatitis B immunization: a global review of recent studies (1994–2000)," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 751-774, December.
    5. Sterman, J.D., 2006. "Learning from evidence in a complex world," American Journal of Public Health, American Public Health Association, vol. 96(3), pages 505-514.
    6. Radboud J. Duintjer Tebbens & Nalinee Sangrujee & Kimberly M. Thompson, 2006. "The Costs of Future Polio Risk Management Policies," Risk Analysis, John Wiley & Sons, vol. 26(6), pages 1507-1531, December.
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    Cited by:

    1. Kimberly M. Thompson & Dominika A. Kalkowska & Kamran Badizadegan, 2021. "A Health Economic Analysis for Oral Poliovirus Vaccine to Prevent COVID‐19 in the United States," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 376-386, February.
    2. Kimberly M. Thompson & Dominika A. Kalkowska & Kamran Badizadegan, 2021. "No Role for Reintroducing OPV into the United States with Respect to Controlling COVID‐19 [Response to the letter to the Editor by Chumakov et al.]," Risk Analysis, John Wiley & Sons, vol. 41(2), pages 389-392, February.
    3. Kimberly M. Thompson & Nima D. Badizadegan, 2017. "Modeling the Transmission of Measles and Rubella to Support Global Management Policy Analyses and Eradication Investment Cases," Risk Analysis, John Wiley & Sons, vol. 37(6), pages 1109-1131, June.
    4. Kimberly M. Thompson & Radboud J. Duintjer Tebbens, 2016. "Framework for Optimal Global Vaccine Stockpile Design for Vaccine‐Preventable Diseases: Application to Measles and Cholera Vaccines as Contrasting Examples," Risk Analysis, John Wiley & Sons, vol. 36(7), pages 1487-1509, July.

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