The average cost of measles cases and adverse events following vaccination in industrialised countries.
BACKGROUND
Even though the annual incidence rate of measles has dramatically decreased in industrialised countries since the implementation of universal immunisation programmes, cases continue to occur in countries where endemic measles transmission has been interrupted and in countries where adequate levels of immunisation coverage have not been maintained. The objective of this study is to develop a model to estimate the average cost per measles case and per adverse event following measles immunisation using the Netherlands (NL), the United Kingdom (UK) and Canada as examples.


METHODS
Parameter estimates were based on a review of the published literature. A decision tree was built to represent the complications associated with measles cases and adverse events following immunisation. Monte-Carlo Simulation techniques were used to account for uncertainty.


RESULTS
From the perspective of society, we estimated the average cost per measles case to be US$276, US$307 and US$254 for the NL, the UK and Canada, respectively, and the average cost of adverse events following immunisation per vaccinee to be US$1.43, US$1.93 and US$1.51 for the NL, UK and Canada, respectively.


CONCLUSIONS
These average cost estimates could be combined with incidence estimates and costs of immunisation programmes to provide estimates of the cost of measles to industrialised countries. Such estimates could be used as a basis to estimate the potential economic gains of global measles eradication.
Carabin
Hélène
H
Department of Infectious Disease Epidemiology, Imperial College Faculty of Medicine, London, UK. helene-carabin@ouhsc.edu
Edmunds
W John
WJ
Kou
Ulla
U
van den Hof
Susan
S
Nguyen
Van Hung
VH
D002170:Canada / Q000453:epidemiology; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D019049:Developed Countries / Q000191:economics*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D032541:Mass Vaccination / Q000009:adverse effects / Q000191:economics; D008457:Measles / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000009:adverse effects* / Q000191:economics*; D017059:Models, Econometric; D009426:Netherlands / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
D008458:Measles Vaccine