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

Koen B. Pouwels*, Eelko Hak, Arie Van Der Ende, Hannah Christensen, Germie P. J. M. Van Den Dobbelsteen, Maarten J. Postma

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

39 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1129-1138
Number of pages10
JournalHuman vaccines & immunotherapeutics
Volume9
Issue number5
DOIs
Publication statusPublished - May-2013

Keywords

  • meningococcal B
  • cost-effectiveness
  • vaccine
  • infants
  • disease incidence
  • SEROGROUP-B
  • CONJUGATE VACCINE
  • HERD-IMMUNITY
  • BACTERIAL-MENINGITIS
  • ECONOMIC-EVALUATION
  • DISEASE
  • NETHERLANDS
  • CHILDREN
  • METAANALYSIS
  • CARRIAGE

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