Cost-effectiveness of universal vaccination ag ainst varicella in the Netherlands

P.T. De Boer, M.J. Postma

    Research output: Contribution to journalMeeting AbstractAcademic

    Abstract

    Objectives: The Netherlands has no varicella vaccination in its National Immunization Program (NIP). Although varicella is regarded as a mild disease, implementation of varicella vaccination in the immunization schedule of several countries has shown to be cost-effective. Dutch children are infected with varicella zoster virus at younger age and make less use of the health care system as compared to other European countries. Therefore, a specific cost-effectiveness study of varicella vaccination for The Netherlands is needed. We aimed to estimate the incremental costeffectiveness ratio (ICER) of universal vaccination of children against varicella in the Dutch NIP as compared with no such vaccination. Methods: A static cohort model was developed to assess the cost-effectiveness of varicella childhood vaccination in the first 30 years. Several vaccination strategies were explored by varying the age of the booster vaccination. Dutch sources of varicella incidence and health care use were combined with vaccine efficacy data from other countries. This study was performed from the societal perspective as well as from the payer's perspective. Results were expressed in euros (€ ) per quality-adjusted life year (QALY) gained. Results: Vaccinating a birth-cohort of 180,000 children could avert 105,091 varicella cases and save 301.1 QALYs and € 13.7 million of direct and indirect costs. The optimal vaccinating-strategy from cost-effectiveness point of view was vaccinating at 14 months and 4 years. This scenario resulted in an ICER of € 2844/QALY gained from the societal perspective and € 40,582/QALY gained from the health care payer's perspective, when a vaccine price of € 45 was used. Results were sensitive to vaccine price, waning rate of the second vaccination and indirect costs. Conclusions: Introduction of varicella vaccination in the Dutch NIP would be cost-effective from the societal perspective when a threshold of € 20.000/QALY gained was used, which corresponds to the minimum threshold mentioned for the Dutch context.
    Original languageEnglish
    Pages (from-to)A357
    Number of pages1
    JournalValue in Health
    Volume16
    Issue number7
    DOIs
    Publication statusPublished - 1-Nov-2013

    Keywords

    • silver
    • vaccine
    • cost effectiveness analysis
    • vaccination
    • chickenpox
    • Netherlands
    • human
    • child
    • quality adjusted life year
    • immunization
    • health care
    • preventive health service
    • health care utilization
    • childhood
    • model
    • health care system
    • Varicella zoster virus

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