A Cost-Effectiveness Analysis of a Hypothetical Dengue Vaccination Campaign in Bolivia

Abstract: This thesis aims to perform a cost-effectiveness analysis for a hypothetical vaccination campaign against dengue fever in Bolivia, a low-income country with endemic risk of Dengue in the eastern lowlands of the country. A vaccination campaign is evaluated using a societal perspective and accounting for different disease incidence rates. The analysis is based on a Markov model previously used in neighboring Argentina and adapted to the Bolivian context by use of information published in scientific journals and information obtained by personal communication with Bolivian doctors. The vaccination campaign was found likely to be cost-effective when the clinical/suspected case incidence is used. Cost-effectiveness is not given when only the laboratory confirmed case incidence is used. The results are similar for a sensitivity analysis that accounted for differences in costs for treatment or vaccination. A probabilistic analysis yielded a probability of 100% at the three-times GDP per capita threshold of 9,231 US$ for the clinical incidence and correspondingly a 56% probability of cost-effectiveness for the lower incidence measure.