Cost-utility analysis of a nationwide vaccination programme against serogroup B meningococcal disease in Israel.
OBJECTIVE
Using cost-utility analysis, to evaluate whether or not to adopt a Neisseria meningitidis serogroup B vaccination programme for Israeli children.


METHODS
Epidemiological, demographic, health service utilisation and economic data were integrated into a spreadsheet model to calculate the cost per averted disability-adjusted life year (DALY) of the intervention.


RESULTS
Assuming 78 % vaccine efficacy with no herd immunity, vaccination will prevent 223 cases and 22 deaths over a 100-year period. Based on vaccine price of $60 per dose, total intervention costs ($315,400,000) are partially offset by a $22,700,000 reduction in treatment and sequelae costs as a result of decreased morbidity. The intervention was not cost-effective since the net cost ($292,700,000) per averted DALY gained (1249 mostly due to decreased mortality) was $234,394. Additional two dose catch-up programmes vaccinating children in cohorts aged 1-2 to 1-13 were also not cost-effective.


CONCLUSIONS
The vaccination will become cost-effective if vaccine costs fall below $19.44 per dose. However, in identified high risk areas, the vaccine would be cost-effective and could be recommended for use both with and without catch-up campaigns.
Department of Technology Assessment, Public Health Service, Ministry of Health, Jerusalem, Israel. gary.ginsberg@moh.health.gov.il.
Gary M
GM
Ginsberg
Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Centre, Ein Kerem, Jerusalem, Israel.
Colin
C
Block
Jerusalem District Health Office, Ministry of Health, Jerusalem, Israel.|Braun School of Public Health and Community Medicine, The Hebrew University and Hadassah, Ein Kerem, Jerusalem, Israel.
Chen
C
Stein-Zamir
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007223:Infant; D007557:Israel; D008297:Male; D008589:Meningococcal Infections / Q000191:economics* / Q000276:immunology / Q000517:prevention & control; D018803:Models, Economic; D038541:Neisseria meningitidis, Serogroup B / Q000276:immunology; D019057:Quality-Adjusted Life Years; D014611:Vaccination / Q000191:economics*
Cost-utility analysis; Economic evaluation; Meningococcal B; Vaccination