Cost-effectiveness of vaccination against meningococcal B among Dutch infants: Crucial impact of changes in incidence.
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ABSTRACT: Objective
Recently, a vaccine with the capacity to protect against serogroup B meningococcal (MenB) disease received a positive opinion of the European Medicines Agency. Previously, such a vaccine was estimated to be cost-effective. However, since then, the MenB disease incidence has declined drastically in the Netherlands. Therefore, we re-assessed the potential incremental cost-effectiveness ratio (ICER) of vaccinating infants in the Netherlands with a MenB vaccine.Results
Routine infant vaccination (2, 3, 4+11 mo) could prevent 39 cases of MenB disease in a single birth cohort, corresponding to a total gain of 133 quality-adjusted life years (QALYs). However, this strategy is unlikely to be cost-effective if the vaccine costs €40 per dose (€243,778 per QALY). At a disease incidence of 5.7 per 100,000 person-years or a vaccine price of €10 per dose including administration costs, the ICER becomes more acceptable and remains below a threshold of €50,000 per QALY.Methods
A cohort of 185,000 Dutch newborns was followed in a Markov model to compare routine vaccination against MenB disease with no vaccination. The ICER was estimated for different disease incidences. The study was performed from a societal perspective.Conclusions
At the current low level of disease incidence, introduction of routine infant vaccination, following a 2, 3, 4+11 mo schedule, against MenB disease is unlikely cost-effective in the Netherlands. If the MenB disease incidence increases or the vaccine price is substantially lower than €40, routine infant vaccination has the potential to be cost-effective.
SUBMITTER: Pouwels KB
PROVIDER: S-EPMC3899149 | biostudies-literature | 2013 May
REPOSITORIES: biostudies-literature
Publications
Cost-effectiveness of vaccination against meningococcal B among Dutch infants: Crucial impact of changes in incidence.
Pouwels Koen B KB Hak Eelko E van der Ende Arie A Christensen Hannah H van den Dobbelsteen Germie P J M GP Postma Maarten J MJ
Human vaccines & immunotherapeutics 20130213 5
<h4>Objective</h4>Recently, a vaccine with the capacity to protect against serogroup B meningococcal (MenB) disease received a positive opinion of the European Medicines Agency. Previously, such a vaccine was estimated to be cost-effective. However, since then, the MenB disease incidence has declined drastically in the Netherlands. Therefore, we re-assessed the potential incremental cost-effectiveness ratio (ICER) of vaccinating infants in the Netherlands with a MenB vaccine.<h4>Results</h4>Rout ...[more]
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