Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Potential cost-effectiveness of a maternal Group B streptococcal vaccine in The Gambia

Ahmed, N; Giorgakoudi, K; Usuf, E; Okomo, U; Clarke, E; Kampmann, B; Le Doare, K; Trotter, C (2020) Potential cost-effectiveness of a maternal Group B streptococcal vaccine in The Gambia. Vaccine, 38 (15). pp. 3096-3104. ISSN 0264-410X
SGUL Authors: Le Doare, Kirsty

[img] Microsoft Word (.docx) Accepted Version
Restricted to Repository staff only until 5 March 2021.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (298kB)


Objective To estimate neonatal health benefits and healthcare provider costs of a theoretical Group B streptococcal (GBS) hexavalent maternal vaccination programme in The Gambia, a low-income setting in West Africa. Methods A static decision analytic cost-effectiveness model was developed from the healthcare provider perspective. Demographic data and acute care costs were available from studies in The Gambia undertaken in 2012–2015. Further model parameters were taken from United Nations and World Health Organisation sources, supplemented by data from a global systematic review of GBS and literature searches. As vaccine efficacy is not known, we simulated vaccine efficacy estimates of 50–90%. Costs are reported in US dollars. Cost-effectiveness thresholds of one (US$473, very cost effective) and three (US$1420, cost effective) times Gambian GDP were used. Results Vaccination with a hexavalent vaccine would avert 24 GBS disease cases (55%) and 768 disability adjusted life years compared to current standard of care (no interventions to prevent GBS disease). At vaccine efficacy of 70%, the programme is cost-effective at a maximum vaccine price per dose of 12 US$ (2016 US$), and very cost-effective at a maximum of $3/dose. The total costs of vaccination at $12 is $1,056,962 for one annual cohort of Gambian pregnant women. One-way sensitivity analysis showed that GBS incidence was the most influential parameter on the cost effectiveness ratio. Conclusion The introduction of a hexavalent vaccine would considerably reduce the current burden of GBS disease in The Gambia but to be cost-effective, the vaccine price per dose would need to be $12/dose or less.

Item Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Vaccine
ISSN: 0264-410X
30 March 2020Published
5 March 2020Published Online
24 February 2020Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
Project IDFunderFunder ID
WT104482MAWellcome Trust
12250Thrasher Research Fund
MC_UP_A900/1122Medical Research Council
MC_UP_A900/115Medical Research Council
UNSPECIFIEDDepartment for International Development
Publisher's version:

Actions (login required)

Edit Item Edit Item