The economic value of childhood varicella vaccination in France and Germany.
OBJECTIVE
To determine the economic impact of childhood varicella vaccination in France and Germany.


METHODS
A common methodology based on the use of a varicella transmission model was used for the two countries. Cost data (2002 per thousand) were derived from two previous studies. The analysis focused on a routine vaccination program for which three different coverage rates (CRs) were considered (90%, 70%, and 45%). Catch-up strategies were also analyzed. A societal perspective including both direct and indirect costs and a third-party payer perspective were considered (Social Security in France and Sickness Funds in Germany).


RESULTS
A routine vaccination program has a clear positive impact on varicella-related morbidity in both countries. With a 90% CR, the number of varicella-related deaths was reduced by 87% in Germany and by 84% in France. In addition, with a CR of 90%, routine varicella vaccination induces savings in both countries from both societal (Germany 61%, France 60%) and third-party payer perspectives (Germany 51%, France 6.7%). For lower CRs, routine vaccination remains cost saving from a third-party payer perspective in Germany but not in France, where it is nevertheless cost-effective (cost per life-year gained of 6521 per thousand in the base case with a 45% CR).


CONCLUSIONS
Considering the impact of vaccination on varicella morbidity and costs, a routine varicella vaccination program appears to be cost saving in Germany and France from both a societal and a third-party payer perspective. For France, routine varicella vaccination remains cost-effective in worst cases when a third-party payer perspective is adopted. Catch-up programs provide additional savings.
Coudeville
Laurent
L
CRESGE-LABORES, Catholic University of Lille, France.
Brunot
Alain
A
Szucs
Thomas D
TD
Dervaux
Benoit
B
D017677:Age Distribution; D002644:Chickenpox / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D019433:Chickenpox Vaccine / Q000191:economics* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D017046:Cost Savings / Q000706:statistics & numerical data*; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000145:classification / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs / Q000191:economics* / Q000706:statistics & numerical data; D007223:Infant; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D008297:Male; D017059:Models, Econometric; D009313:National Health Programs / Q000191:economics; D015397:Program Evaluation
D019433:Chickenpox Vaccine