title: Health economics of a hexavalent meningococcal outer-membrane vesicle vaccine in children: potential impact of introduction in the Dutch vaccination program.
abstract: The cost-effectiveness of universal vaccination of infants with a new hexavalent meningococcal B outer-membrane vesicle vaccine is projected for The Netherlands by applying decision analysis. The societal perspective is taken and direct and productivity costs (friction costs method) are considered. Future costs and effects are discounted at 4% (base year 1998). In this simulation model, vaccination would prevent 19 deaths and eight cases with severe long-term sequelae per year, rendering 526 additional quality adjusted life years (QALYs) per year. Yearly costs of acute phase of illness due to meningococcal infections in children are estimated at 1,426,634, while the future costs due to sequelae are estimated at 3,801,121 per year. Of all these costs, the vaccination program could prevent 3,334,052 per year. The program costs of meningococcal vaccination are estimated at 11,601,356, resulting in a cost-effectiveness ratio (CER) of 15,721 per QALY. These results are sensitive to the vaccine dose price (conservatively estimated at 10), efficacy, and coverage of meningococcal sero-subtypes.
authors.affiliation: Department of Health Services Research, National Institute of Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. j.bos@farm.rug.nl
authors.forename: J M
authors.initials: JM
authors.lastname: Bos
authors.forename: H C
authors.initials: HC
authors.lastname: Rümke
authors.forename: R
authors.initials: R
authors.lastname: Welte
authors.forename: M J
authors.initials: MJ
authors.lastname: Postma
authors.forename: J C
authors.initials: JC
authors.lastname: Jager
mesh_terms: D001425:Bacterial Outer Membrane Proteins / Q000276:immunology; D002675:Child, Preschool; D003198:Computer Simulation; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008589:Meningococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D022401:Meningococcal Vaccines / Q000191:economics* / Q000276:immunology; D008962:Models, Theoretical; D009426:Netherlands; D014611:Vaccination / Q000191:economics*
chemical_list: D001425:Bacterial Outer Membrane Proteins; D022401:Meningococcal Vaccines; C090348:Opa protein, Neisseria