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Immunization to Prevent Insulin-Dependent Diabetes Mellitus?: The Economics of Genetic Screening and Vaccination for Diabetes

WILLIAM L. ENGLAND, M.S.E.E.; and STEPHEN D. ROBERTS, Ph.D.
[+] Article and Author Information

Grant support: in part by grant P 60 AM 20542 from the National Institutes of Health.

▸Requests for reprints should be addressed to Stephen D. Roberts, Ph.D.; 1001 West Tenth Street; Indianapolis, IN 46202.


Indianapolis, Indiana


© 1981 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1981;94(3):395-400. doi:10.7326/0003-4819-94-3-395
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There is increasing evidence that some cases of insulindependent diabetes mellitus are virally induced, and vaccination against this disease may become possible. We have prospectively examined the costs and benefits that would occur if a diabetes vaccine were developed, using a decision tree to model the alternative vaccination policies, including histocompatibility leukocyte antigen (HLA) screening. We found many cost and likelihood data in the literature, and when data on the potential vaccine had to be hypothesized, we used sensitivity analysis to check our estimates. We conclude that vaccinating all children at age 3 would be preferable to HLA screening and vaccinating only persons with a genetic predisposition to developing diabetes. A 50% effective vaccine would cut the diabetes incidence rate by 29% and save the U.S. population $30 million annually in direct costs of diabetes care. If indirect costs are considered these savings could amount to $4.2 billion over 60 years, discounted to present value at 5%, while preventing over 200 000 cases of insulin-dependent diabetes.

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