Health Impact and Cost-effectiveness Assessment for the Introduction of Universal Varicella Vaccination in Switzerland
| Autor: | Ray Gani, Salome Samant, Ulrich Heininger, Manjiri Pawaskar, Patrik Guggisberg, Florian Lienert, Elliott O'Brien, M. Pillsbury |
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| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Herpesvirus 3 Human Varicella vaccine Cost effectiveness Cost-Benefit Analysis Health impact Vaccines Administered Varicella vaccination Chickenpox Vaccine 03 medical and health sciences 0302 clinical medicine Chickenpox 030225 pediatrics Environmental health Per capita Medicine Humans 030212 general & internal medicine health care economics and organizations business.industry Immunization Programs Vaccination Infant Hospitalization Infectious Diseases Immunization Pediatrics Perinatology and Child Health Immunization program Health Impact Assessment business Switzerland |
| Zdroj: | The Pediatric infectious disease journal. 40(6) |
| ISSN: | 1532-0987 |
| Popis: | Background Varicella, caused by the varicella-zoster virus, is a highly contagious infectious disease with substantial health and economic burden to society. Universal varicella vaccination (UVV) is not yet recommended by the Swiss National Immunization Program, which instead recommends catch-up immunization for children, adolescents and adults 11-40 years of age who have no reliable history of varicella or are varicella-zoster virus-IgG seronegative. The objective of this study was to perform an assessment of health impact and cost-effectiveness comparing UVV with current practice and recommendations in Switzerland. Methods A dynamic transmission model for varicella was adapted to Switzerland comparing 2 base-case schedules (no infant vaccination and 10% coverage with infant vaccination) to 3 different UVV schedules using quadrivalent (varicella vaccine combined with measles-mumps-rubella) and standalone varicella vaccines administered at different ages. Modeled UVV coverage rates were based on current measles-mumps-rubella coverage of approximately 95% (first dose) and 90% (second dose). Direct medical costs and societal perspectives were considered, with cost and outcomes discounted and calculated over a 50-year time horizon. Results UVV would reduce the number of varicella cases by 88%-90%, hospitalizations by 62%-69% and deaths by 75%-77%. UVV would increase direct medical costs by Swiss Franc (CHF) 39-49 (US $43-54) per capita and costs from a societal perspective by CHF 32-40 (US $35-44). Incremental quality-adjusted life-years per capita increased by 0.0012-0.0014. Incremental cost-effectiveness ratios for the UVV schedules versus the base-case were CHF 31,194-35,403 (US $34,452-39,100) per quality-adjusted life-year from the direct medical cost perspective and CHF 25,245-29,552 (US $27,881-32,638) from the societal perspective. Conclusions UVV appears highly effective and cost-effective when compared with current clinical practice and recommendations in Switzerland from both a direct medical costs perspective and societal perspective. |
| Databáze: | OpenAIRE |
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