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Hum Vaccin Immunother. 2013 May;9(5):1129-38. doi: 10.4161/hv.23888. Epub 2013 Feb 13.

Cost-effectiveness of vaccination against meningococcal B among Dutch infants: Crucial impact of changes in incidence.

Author information

1
Unit of PharmacoEpidemiology and PharmacoEconomics (PE); Department of Pharmacy; University of Groningen; Groningen, the Netherlands.

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.

KEYWORDS:

cost-effectiveness; disease incidence; infants; meningococcal B; vaccine

PMID:
23406816
PMCID:
PMC3899149
DOI:
10.4161/hv.23888
[Indexed for MEDLINE]
Free PMC Article

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