Cost-utility analysis of a nationwide vaccination programme against serogroup B meningococcal disease in Israel

Int J Public Health. 2016 Jul;61(6):683-692. doi: 10.1007/s00038-016-0821-0. Epub 2016 Apr 22.

Abstract

Objectives: Using cost-utility analysis, to evaluate whether or not to adopt a Neisseria meningitidis serogroup B vaccination programme for Israeli children.

Methods: Epidemiological, demographic, health service utilisation and economic data were integrated into a spreadsheet model to calculate the cost per averted disability-adjusted life year (DALY) of the intervention.

Results: Assuming 78 % vaccine efficacy with no herd immunity, vaccination will prevent 223 cases and 22 deaths over a 100-year period. Based on vaccine price of $60 per dose, total intervention costs ($315,400,000) are partially offset by a $22,700,000 reduction in treatment and sequelae costs as a result of decreased morbidity. The intervention was not cost-effective since the net cost ($292,700,000) per averted DALY gained (1249 mostly due to decreased mortality) was $234,394. Additional two dose catch-up programmes vaccinating children in cohorts aged 1-2 to 1-13 were also not cost-effective.

Conclusions: The vaccination will become cost-effective if vaccine costs fall below $19.44 per dose. However, in identified high risk areas, the vaccine would be cost-effective and could be recommended for use both with and without catch-up campaigns.

Keywords: Cost-utility analysis; Economic evaluation; Meningococcal B; Vaccination.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis*
  • Female
  • Humans
  • Immunization Programs / economics*
  • Infant
  • Israel
  • Male
  • Meningococcal Infections / economics*
  • Meningococcal Infections / immunology
  • Meningococcal Infections / prevention & control
  • Models, Economic
  • Neisseria meningitidis, Serogroup B* / immunology
  • Quality-Adjusted Life Years
  • Vaccination / economics*