A new study from researchers at the London School of Hygiene and Tropical Medicine, Boston University School of Public Health, Harvard T.H. Chan School of Public Health, and the National Tuberculosis Elimination Program in India estimates the potential health and economic impact of introducing M72/AS01E and BCG-revaccination in Delhi and Gujarat, the highest TB burden and lowest TB burden states in India, respectively.
Given the assumed vaccine and delivery characteristics, they found that M72/AS01E delivery strategies could avert more cases in Delhi than BCG-revaccination delivery strategies. Compared to assumed cost-effectiveness thresholds in India, M72/AS01E and BCG-revaccination scenarios were likely to be cost-effective (or even cost-saving) in Delhi. BCG-revaccination scenarios were also estimated to be cost-effective in Gujarat compared to assumed cost-effectiveness thresholds, but M72/AS01E scenarios were likely to be cost-effective only if, given the lower prevalence of TB infection in this setting, we assumed that vaccine efficacy could impact both current and future infections rather than only current infections at the time of vaccination.
If there continue to be positive results from completed and ongoing trials leading to eventual licensure and introduction of a novel TB vaccination program, the results of this paper could help decision makers think about the value of potential delivery strategies and subnational contexts for M72/AS01E and BCG-revaccination in India.
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