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Dr. Hsia's work was supported by a Physician Scientist Development Award from the Arthritis Foundation.
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Original Article
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Cost-effectiveness analysis of the Lyme disease vaccine
Article first published online: 6 JUN 2002
DOI: 10.1002/art.10270
Copyright © 2002 by the American College of Rheumatology
Additional Information
How to Cite
Hsia, E. C., Chung, J. B., Schwartz, J. S. and Albert, D. A. (2002), Cost-effectiveness analysis of the Lyme disease vaccine. Arthritis & Rheumatism, 46: 1651–1660. doi: 10.1002/art.10270
Publication History
- Issue published online: 6 JUN 2002
- Article first published online: 6 JUN 2002
- Manuscript Accepted: 25 JAN 2002
- Manuscript Received: 26 MAR 2001
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Abstract
Objective
A vaccine for Lyme disease was approved in 1998 for use in the US. Given the high cost of the vaccine, the low risk of Lyme disease in many areas, and the largely curable nature of the disease, the cost-effectiveness of the vaccine in various risk groups is uncertain. This study was undertaken to examine the cost-effectiveness of the Lyme disease vaccine and the factors that influence its cost-effectiveness.
Methods
We constructed a Markov decision-analysis model to evaluate the clinical effectiveness and cost-effectiveness of the Lyme disease vaccine in populations at various levels of risk for the disease. The probabilities of clinical events and costs were estimated from reports in the literature. Sensitivity analyses assessed the impact of potential variations of parameters on model results.
Results
At the average national incidence of Lyme disease (0.0067%), the incremental cost-effectiveness of vaccination was ∼$1,600,000 per case averted when a yearly booster was given for 10 years after the standard initial vaccination regimen of 3 inoculations at 0, 1, and 12 months. For populations with an annual Lyme disease incidence of 1% (the incidence in several well-defined geographical areas of the US), the incremental cost-effectiveness was ∼$9,900 per case averted. Disease incidence had to exceed 10% before vaccination with yearly boosters became both more effective and more cost saving than no vaccination.
Conclusion
The Lyme disease vaccine is cost-effective only for individuals who live in areas where Lyme disease is endemic and who are frequently exposed to ticks.