VPM1002 for tuberculosis prevention in India: a 1,296-compartment dynamic model with disaggregated pulmonary and extrapulmonary efficacy, Bayesian evidence synthesis, and dual-perspective health economics

Tuberculosis kills 1.3 million people annually worldwide. The PreVenTB Phase III study tested the VPM1002 vaccine in household contacts aged over 6 years in India. Researchers developed a mathematical model with 1,296 compartments to analyze vaccine efficacy against pulmonary and extrapulmonary tuberculosis. Results showed the vaccine had higher efficacy against extrapulmonary tuberculosis (40.0%) than against pulmonary disease (12.8%). Extrapulmonary tuberculosis accounted for 74% of averted deaths and 73% of averted disability-adjusted life years. According to economic analysis from a societal perspective, the benefit-cost ratio was 3.4 to 8.2 and the cost per averted disability-adjusted life year was 647 to 1,568 US dollars, which is below India's established threshold.