TY - JOUR
T1 - The potential impact of novel tuberculosis vaccine introduction on economic growth in low- and middle-income countries
T2 - A modeling study
AU - Portnoy, Allison
AU - Arcand, Jean Louis
AU - Clark, Rebecca A.
AU - Weerasuriya, Chathika K.
AU - Mukandavire, Christinah
AU - Bakker, Roel
AU - Patouillard, Edith
AU - Gebreselassie, Nebiat
AU - Zignol, Matteo
AU - Jit, Mark
AU - White, Richard G.
AU - Menzies, Nicolas A.
N1 - Publisher Copyright:
Copyright: © 2023 Portnoy et al.
PY - 2023/7
Y1 - 2023/7
N2 - Background Most individuals developing tuberculosis (TB) are working age adults living in low- and middle-income countries (LMICs). The resulting disability and death impact economic productivity and burden health systems. New TB vaccine products may reduce this burden. In this study, we estimated the impact of introducing novel TB vaccines on gross domestic product (GDP) growth in 105 LMICs. Methods and findings We adapted an existing macroeconomic model to simulate country-level GDP trends between 2020 and 2080, comparing scenarios for introduction of hypothetical infant and adolescent/adult vaccines to a no-new-vaccine counterfactual. We parameterized each scenario using estimates of TB-related mortality, morbidity, and healthcare spending from linked epidemiological and costing models. We assumed vaccines would be introduced between 2028 and 2047 and estimated incremental changes in GDP within each country from introduction to 2080, in 2020 US dollars. We tested the robustness of results to alternative analytic specifications. Both vaccine scenarios produced greater cumulative GDP in the modeled countries over the study period, equivalent to $1.6 (95% uncertainty interval: $0.8, 3.0) trillion for the adolescent/adult vaccine and $0.2 ($0.1, 0.4) trillion for the infant vaccine. These GDP gains were substantially lagged relative to the time of vaccine introduction, particularly for the infant vaccine. GDP gains resulting from vaccine introduction were concentrated in countries with higher current TB incidence and earlier vaccine introduction. Results were sensitive to secular trends in GDP growth but relatively robust to other analytic assumptions. Uncertain projections of GDP could alter these projections and affect the conclusions drawn by this analysis. Conclusions Under a range of assumptions, introducing novel TB vaccines would increase economic growth in LMICs.
AB - Background Most individuals developing tuberculosis (TB) are working age adults living in low- and middle-income countries (LMICs). The resulting disability and death impact economic productivity and burden health systems. New TB vaccine products may reduce this burden. In this study, we estimated the impact of introducing novel TB vaccines on gross domestic product (GDP) growth in 105 LMICs. Methods and findings We adapted an existing macroeconomic model to simulate country-level GDP trends between 2020 and 2080, comparing scenarios for introduction of hypothetical infant and adolescent/adult vaccines to a no-new-vaccine counterfactual. We parameterized each scenario using estimates of TB-related mortality, morbidity, and healthcare spending from linked epidemiological and costing models. We assumed vaccines would be introduced between 2028 and 2047 and estimated incremental changes in GDP within each country from introduction to 2080, in 2020 US dollars. We tested the robustness of results to alternative analytic specifications. Both vaccine scenarios produced greater cumulative GDP in the modeled countries over the study period, equivalent to $1.6 (95% uncertainty interval: $0.8, 3.0) trillion for the adolescent/adult vaccine and $0.2 ($0.1, 0.4) trillion for the infant vaccine. These GDP gains were substantially lagged relative to the time of vaccine introduction, particularly for the infant vaccine. GDP gains resulting from vaccine introduction were concentrated in countries with higher current TB incidence and earlier vaccine introduction. Results were sensitive to secular trends in GDP growth but relatively robust to other analytic assumptions. Uncertain projections of GDP could alter these projections and affect the conclusions drawn by this analysis. Conclusions Under a range of assumptions, introducing novel TB vaccines would increase economic growth in LMICs.
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U2 - 10.1371/journal.pmed.1004252
DO - 10.1371/journal.pmed.1004252
M3 - Article
C2 - 37432972
AN - SCOPUS:85164416508
SN - 1549-1277
VL - 20
JO - PLoS Medicine
JF - PLoS Medicine
IS - 7 July
M1 - e1004252
ER -