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Vaccine. 2016 Apr 27;34(19):2240-50. doi: 10.1016/j.vaccine.2016.03.020. Epub 2016 Mar 19.

Epidemiological impact and cost-effectiveness of introducing vaccination against serogroup B meningococcal disease in France.

Author information

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.

KEYWORDS:

Cost-effectiveness; Meningococcal; Serogroup B; Vaccine

PMID:
27002504
DOI:
10.1016/j.vaccine.2016.03.020
[Indexed for MEDLINE]

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