title: Cost-effectiveness analysis of a multicomponent meningococcal serogroup B vaccine in hypothetic epidemic situation in a middle-income country.
abstract: NmenB vaccine (4CMenB) is now available, but studies on the cost-effectiveness of vaccine introduction in a country outbreak situation are lacking. The aim of this study was to evaluate the cost-effectiveness of 4CMenB in the context of a hypothetical epidemic outbreak in Chile. We analyzed the direct and indirect costs of acute disease, sequelae and death for each case of meningococcal disease (MD) based on information obtained during the latest NmenB outbreak in Santiago, Chile, occurring between 1993-1999, with an incidence of 5.9/100,000 inhabitants and a mortality of 7.3%. We analyzed the cost of a mass vaccination campaign, considering one dose of 4CMenB for population between 12 months and 25 y of age and 3 doses for infants. Cost-effectiveness analysis was based on 80% and 92% 4CMenB immunogenicity for individual's bellow and over 12 months respectively. Sensitivity analysis was applied to different vaccine costs.
  
  
  RESULTS
  The total cost of the epidemic was USD $59,967,351, considering individual cost of each acute case (USD$2,685), sequelae (USD$2,374) and death (USD $408,086). In Chile, the 4CMenB mass vaccination strategy would avoid 215 cases, 61 sequelae, and 16 deaths per year. The strategy would be cost-effective at a vaccine dose cost ≤ of USD$18.
  
  
  CONCLUSIONS
  Implementation of a mass vaccination campaign to control a hypothetical NmenB outbreak in Chile would be cost-effective at a vaccine cost per dose ≤ of USD$18. This is the first report of a cost-effectiveness analysis for use of 4CMenB as a single intervention strategy to control an epidemic outbreak of NmenB.
authors.affiliation: a Department of Pediatrics; Division of Pediatric Infectious Diseases; Faculty of Medicine ; Universidad de Chile ; Santiago , Chile.
authors.forename: Giannina
authors.initials: G
authors.lastname: Izquierdo
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Torres
authors.forename: M Elena
authors.initials: ME
authors.lastname: Santolaya
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Valenzuela
authors.forename: Jeannette
authors.initials: J
authors.lastname: Vega
authors.forename: May
authors.initials: M
authors.lastname: Chomali
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis / Q000379:methods*; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000517:prevention & control; D022401:Meningococcal Vaccines / Q000191:economics*; D038541:Neisseria meningitidis, Serogroup B / Q000276:immunology; D065288:Serogroup; D055815:Young Adult
chemical_list: D022401:Meningococcal Vaccines
keywords: Cerebrospinal fluid; Gross domestic product; CSF; MD; Meningococcal disease; Nmen; Neisseria meningitidis; 4CMenB; Serogroup B meningococcal vaccine; GDP; cost-effectiveness analysis; meningococcal disease; meningococcal vaccine; outbreak