CHDS postdoctoral fellow Allison Portnoy and CHDS faculty Nick Menzies estimated the future costs, cost-effectiveness, and return on investment from novel tuberculosis (TB) vaccines in low- and middle-income countries (LMICs) in a recently conducted modeling study. These estimates depend on vaccine price and delivery strategy that may vary by country, and are needed by vaccine developers, manufacturers, and potential purchasers to guide investment decisions. The authors found that novel TB vaccination would be cost-effective in most of 105 different LMICs, with an adolescent/adult vaccine product projected to be cost-effective compared to a 1x per-capita gross domestic product threshold in 70% of analyzed LMICs, and cost-saving in 55%, including 96% of countries classified by the World Health Organization as having high TB burden. When considering the monetized value of health gains, the study estimated that introduction of an adolescent/adult TB vaccine could produce $283–474 billion in health and economic benefits by 2050, with greater benefits in LMICs with elevated TB incidence.
TB vaccines are still under development, so their potential effectiveness and impact are uncertain. Accelerating the timeline for vaccine introduction, decreasing the vaccine price, or increasing vaccine efficacy could all affect the cost-effectiveness profile of vaccination and increase the magnitude of benefits, directly improving the welfare of individuals and households that would otherwise experience the health and economic consequences of TB in coming years.