Economic evaluation of meningococcal serogroup B childhood vaccination in Ontario, Canada
| Autor: | Natasha S. Crowcroft, Lisa Strifler, Jeffrey C. Kwong, Frances B. Jamieson, Shaun K. Morris, Peter C. Coyte, Shelley L. Deeks, Beate Sander, Hong Anh T. Tu, Murray Krahn |
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| Rok vydání: | 2014 |
| Předmět: |
Pediatrics
medicine.medical_specialty Vaccination schedule Cost-Benefit Analysis Meningococcal Vaccines Disease Neisseria meningitidis Serogroup B Case fatality rate Medicine Humans Adverse effect Ontario General Veterinary General Immunology and Microbiology business.industry Immunization Programs Incidence (epidemiology) Public Health Environmental and Occupational Health Infant Health Care Costs Markov Chains Vaccination Meningococcal Infections Infectious Diseases Economic evaluation Cohort Molecular Medicine Quality-Adjusted Life Years business Demography |
| Zdroj: | Vaccine. 32(42) |
| ISSN: | 1873-2518 |
| Popis: | Objective Invasive Neisseria meningitidis serogroup B (MenB) disease is a low incidence but severe infection (mean annual incidence 0.19/100,000/year, case fatality 11%, major long-term sequelae 10%) in Ontario, Canada. This study assesses the cost-effectiveness of a novel MenB vaccine from the Ontario healthcare payer perspective. Methods A Markov cohort model of invasive MenB disease based on high quality local data and data from the literature was developed. A 4-dose vaccination schedule, 97% coverage, 90% effectiveness, 66% strain coverage, 10-year duration of protection, and vaccine cost of C$75/dose were assumed. A hypothetical Ontario birth cohort (n = 150,000) was simulated to estimate expected lifetime health outcomes, quality-adjusted life years (QALYs), and costs, discounted at 5%. Results A MenB infant vaccination program is expected to prevent 4.6 invasive MenB disease cases over the lifetime of an Ontario birth cohort, equivalent to 10 QALYs gained. The estimated program cost of C$46.6 million per cohort (including C$318,383 for treatment of vaccine-associated adverse events) were not offset by healthcare cost savings of C$150,522 from preventing MenB cases, resulting in an incremental cost of C$4.76 million per QALY gained. Sensitivity analyses showed the findings to be robust. Conclusions An infant MenB vaccination program significantly exceeds commonly used cost-effectiveness thresholds and thus is unlikely to be considered economically attractive in Ontario and comparable jurisdictions. |
| Databáze: | OpenAIRE |
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