Héloïse Lecocq1, Isabelle Parent du Châtelet2, Muhamed-Kheir Taha3, Daniel Lévy-Bruhl4, Benoit Dervaux1. 1. EA 2694, Lille University School of Medicine, France. 2. French Institute for Public Health Surveillance (InVS), Saint-Maurice, France. Electronic address: i.parent@invs.sante.fr. 3. Institut Pasteur, National Reference Center for Meningococci, Paris, France. 4. French Institute for Public Health Surveillance (InVS), Saint-Maurice, France.
Abstract
INTRODUCTION: Despite its low incidence in France, invasive serogroup B meningococcal disease remains a public health concern. A new vaccine against the disease, Bexsero(®), has been licensed in the EU. We studied the epidemiological impact and cost-effectiveness of routine vaccination using Bexsero(®) in order to inform the decision-making process regarding its potential inclusion in the vaccination schedule. METHODS: A multi-generational Markov model was used. Time horizon was set to 100 years. Five vaccination strategies were evaluated: infants at 3, 5, 6 and 13 months, toddlers at 13, 15 and 27 months and adolescents at 15 years provided 2 doses one month apart. A booster dose at 15 years old and a catch-up for 15 years old subjects during the first 15 years of the programme were added to the infant and toddler strategies. Costs per QALY gained were computed from a restricted societal perspective including direct costs only. Herd immunity was simulated in an alternative base-case scenario and sensitivity analyses. RESULTS: In the base-case analysis without herd immunity and with all cohorts vaccinated, at € 40 per vaccine dose, routine infant vaccination would provide the lowest cost per QALY gained (€ 380,973) despite only preventing 18% of cases. Under the assumption of herd immunity, the adolescent vaccination would provide the lowest cost per QALY gained (€ 135,902) preventing 24% of cases. Infant vaccination with a late booster and catch-up would prevent 51% of cases with a cost of € 188,511 per QALY gained. CONCLUSIONS: Given current meningococcal epidemiology in France and the available data on the protection provided by Bexsero(®), our modelling work showed that routine vaccination against serogroup B meningococcal disease is not cost-effective.
INTRODUCTION: Despite its low incidence in France, invasive serogroup B meningococcal disease remains a public health concern. A new vaccine against the disease, Bexsero(®), has been licensed in the EU. We studied the epidemiological impact and cost-effectiveness of routine vaccination using Bexsero(®) in order to inform the decision-making process regarding its potential inclusion in the vaccination schedule. METHODS: A multi-generational Markov model was used. Time horizon was set to 100 years. Five vaccination strategies were evaluated: infants at 3, 5, 6 and 13 months, toddlers at 13, 15 and 27 months and adolescents at 15 years provided 2 doses one month apart. A booster dose at 15 years old and a catch-up for 15 years old subjects during the first 15 years of the programme were added to the infant and toddler strategies. Costs per QALY gained were computed from a restricted societal perspective including direct costs only. Herd immunity was simulated in an alternative base-case scenario and sensitivity analyses. RESULTS: In the base-case analysis without herd immunity and with all cohorts vaccinated, at € 40 per vaccine dose, routine infant vaccination would provide the lowest cost per QALY gained (€ 380,973) despite only preventing 18% of cases. Under the assumption of herd immunity, the adolescent vaccination would provide the lowest cost per QALY gained (€ 135,902) preventing 24% of cases. Infant vaccination with a late booster and catch-up would prevent 51% of cases with a cost of € 188,511 per QALY gained. CONCLUSIONS: Given current meningococcal epidemiology in France and the available data on the protection provided by Bexsero(®), our modelling work showed that routine vaccination against serogroup B meningococcal disease is not cost-effective.
Authors: A R Giuliani; A Mattei; A Appetiti; D Pompei; F Di Donna; F Fiasca; L Fabiani Journal: Hum Vaccin Immunother Date: 2018-06-21 Impact factor: 3.452
Authors: Hannah Christensen; Hareth Al-Janabi; Pierre Levy; Maarten J Postma; David E Bloom; Paolo Landa; Oliver Damm; David M Salisbury; Javier Diez-Domingo; Adrian K Towse; Paula K Lorgelly; Koonal K Shah; Karla Hernandez-Villafuerte; Vinny Smith; Linda Glennie; Claire Wright; Laura York; Raymond Farkouh Journal: Eur J Health Econ Date: 2019-11-21