Projected cost-effectiveness of new vaccines for adolescents in the United States.
BACKGROUND
Economic assessments that guide policy making on immunizations are becoming increasingly important in light of new and anticipated vaccines for adolescents. However, important considerations that limit the utility of these assessments, such as the diversity of approaches used, are often overlooked and should be better understood.


OBJECTIVE
Our goal was to examine economic studies of adolescent vaccines and compare cost-effectiveness outcomes among studies on a particular vaccine, across adolescent vaccines, and between new adolescent vaccines versus vaccines that are recommended for young children.


METHODS
A systematic review of economic studies on immunizations for adolescents was conducted. Studies were identified by searching the Medline, Embase, and EconLit databases. Each study was reviewed for appropriateness of model design, baseline setup, sensitivity analyses, and input variables (ie, epidemiologic, clinical, cost, and quality-of-life impact). For comparison, the cost-effectiveness outcomes reported in key studies on vaccines for younger children were selected.


RESULTS
Vaccines for healthy adolescents were consistently found to be more costly than the health care or societal cost savings they produced and, in general, were less cost-effective than vaccines for younger children. Among the new vaccines, pertussis and human papillomavirus vaccines were more cost-effective than meningococcal vaccines. Including herd-immunity benefits in studies significantly improved the cost-effectiveness estimates for new vaccines. Differences in measurements or assumptions limited further comparisons.


CONCLUSIONS
Although using the new adolescent vaccines is unlikely to be cost-saving, vaccination programs will result in sizable health benefits.
Ortega-Sanchez
Ismael R
IR
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mail Stop A-47, Atlanta, GA 30333, USA. iortegasanchez@cdc.gov
Lee
Grace M
GM
Jacobs
R Jake
RJ
Prosser
Lisa A
LA
Molinari
Noelle-Angelique
NA
Zhang
Xinzhi
X
Baine
William B
WB
McCauley
Mary M
MM
Miller
Ted
T
D000293:Adolescent; D003362:Cost-Benefit Analysis; D006801:Humans; D007252:Influenza Vaccines / Q000191:economics; D018803:Models, Economic; D053918:Papillomavirus Vaccines / Q000191:economics; D010567:Pertussis Vaccine / Q000191:economics; D019057:Quality-Adjusted Life Years; D014481:United States; D014612:Vaccines / Q000191:economics*; D014761:Viral Hepatitis Vaccines / Q000191:economics
D007252:Influenza Vaccines; D053918:Papillomavirus Vaccines; D010567:Pertussis Vaccine; D014612:Vaccines; D014761:Viral Hepatitis Vaccines