title: Vaccinating Italian infants with a new multicomponent vaccine (Bexsero®) against meningococcal B disease: A cost-effectiveness analysis.
abstract: The European Medicines Agency has approved a multicomponent serogroup B meningococcal vaccine (Bexsero®) for use in individuals of 2 months of age and older. A cost-effectiveness analysis (CEA) from the societal and Italian National Health Service perspectives was performed in order to evaluate the impact of vaccinating Italian infants less than 1 y of age with Bexsero®, as opposed to non-vaccination. The analysis was carried out by means of Excel Version 2011 and the TreeAge Pro® software Version 2012. Two basal scenarios that differed in terms of disease incidence (official and estimated data to correct for underreporting) were considered. In the basal scenarios, we considered a primary vaccination cycle with 4 doses (at 2, 4, 6 and 12 months of age) and 1 booster dose at the age of 11 y, the societal perspective and no cost for death. Sensitivity analyses were carried out in which crucial variables were changed over probable ranges. In Italy, on the basis of official data on disease incidence, vaccination with Bexsero® could prevent 82.97 cases and 5.61 deaths in each birth cohort, while these figures proved to be three times higher on considering the estimated incidence. The results of the CEA showed that the Incremental Cost Effectiveness Ratio (ICER) per QALY was €109,762 in the basal scenario if official data on disease incidence are considered and €26,599 if estimated data are considered. The tornado diagram indicated that the most influential factor on ICER was the incidence of disease. The probability of sequelae, the cost of the vaccine and vaccine effectiveness also had an impact. Our results suggest that vaccinating infants in Italy with Bexsero® has the ability to significantly reduce meningococcal disease and, if the probable underestimation of disease incidence is considered, routine vaccination is advisable.
authors.affiliation: a Department of Health Sciences , University of Genoa , Genoa , Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gasparini
authors.affiliation: b Department of Economics , University of Genoa , Genoa , Italy.|c University of Exeter , Medical School , Exeter , UK.
authors.forename: Paolo
authors.initials: P
authors.lastname: Landa
authors.affiliation: a Department of Health Sciences , University of Genoa , Genoa , Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Amicizia
authors.affiliation: a Department of Health Sciences , University of Genoa , Genoa , Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Icardi
authors.affiliation: d Institute of Hygiene and Public Health , Catholic University of Sacred Heart , Rome , Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
authors.affiliation: d Institute of Hygiene and Public Health , Catholic University of Sacred Heart , Rome , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: de Waure
authors.affiliation: b Department of Economics , University of Genoa , Genoa , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tanfani
authors.affiliation: e Department of Health Sciences , University of Florence , Florence , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bonanni
authors.affiliation: f Wichtig International , Milan , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Lucioni
authors.affiliation: b Department of Economics , University of Genoa , Genoa , Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Testi
authors.affiliation: a Department of Health Sciences , University of Genoa , Genoa , Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Panatto
mesh_terms: D002648:Child; D003362:Cost-Benefit Analysis; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008589:Meningococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000008:administration & dosage* / Q000191:economics*; D038541:Neisseria meningitidis, Serogroup B / Q000276:immunology*; D013534:Survival
chemical_list: C570015:4CMenB vaccine; D022401:Meningococcal Vaccines
keywords: Bexsero®; Cost-Effectiveness Analysis (CEA); Neisseria meningitidis B; health economics; meningococcus; vaccination