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PharmacoEconomics
Published in: PharmacoEconomics 2/2006

01-02-2006 | Original Research Article

Combination Vaccine Against Invasive Meningococcal B and Pneumococcal Infections

Potential Epidemiological and Economic Impact in The Netherlands

Authors: Dr Jasper M. Bos, Hans C. Rümke, Robert Welte, Lodewijk Spanjaard, Loek van Alphen, Maarten J. Postma

Published in: PharmacoEconomics | Issue 2/2006

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Abstract

Background

Streptococcus pneumoniae and Neisseria meningitidis group B are among the main causes of invasive bacterial meningitis infections in infants. Worldwide, these diseases lead to significant mortality, morbidity and costs. The societal impact is especially severe since the majority of cases occur in very young infants. A combination vaccine consisting of 9-valent conjugated pneumococcal and meningococcal B components is currently being developed. The aim of this study was to estimate the potential impact and cost effectiveness from the societal perspective of vaccinating infants in The Netherlands with this combination pneumococcal and meningococcal B vaccine versus no vaccination.

Methods

A Markov cycle model was developed using epidemiological and healthcare resource use data from 1996 to 2001. This model was used to project the annual costs, benefits and health gains associated with vaccinating all newborns. The base year for the costing was 2003 and all costs and health effects were discounted at 4%. The results of the analysis are expressed in costs per QALY and both probabilistic and univariate sensitivity analyses were used to identify the robustness of the results.

Results

Annually, an average of 755 cases of invasive pneumococcal and meningococcal B infection occurred in infants aged 0–10 years in The Netherlands. Introduction of the combination vaccine would prevent 201 cases of meningococcal B meningitis and 165 cases of invasive pneumococcal disease per year. Additionally, 3410 cases of pneumococcal pneumonia and 46 350 cases of otitis media would be prevented. Vaccination would save 35 lives per year and prevent 71 cases of severe sequelae. This translates into 860 life-years gained, or 1128 QALYs gained.
Alongside these health gains, vaccination would prevent €17 681 370 of direct medical and indirect costs attributable to meningococcal and pneumococcal infections in The Netherlands. Depending on vaccine price, cost effectiveness varied from €3160 (vaccine price per dose €20) to €32 170 (vaccine price €60 per dose) per QALY. Base-case cost effectiveness (vaccine price €40) was €17 700 per QALY. The model was most sensitive to changes in incidence, vaccine price and duration of protective efficacy.

Conclusion

Our results suggest that the introduction of a combination meningococcal B and pneumococcal vaccine into the Dutch infant vaccination programme is potentially cost effective compared with no vaccination.
Footnotes
1
The expert panel consisted of members of the infectious diseases section of the Dutch Paediatric Society, which consists of representatives of most of the paediatric departments of university hospitals in The Netherlands. The expert panel was consulted on both the resource use of meningococcal and pneumococcal infections as well as assumptions on the severity of disease. Opinions of all specialists were noted and mean values were obtained for resource use (apart from number of inpatient days, which were derived from Prismant Healthcare).[24] For further details regarding the procedure, see Bos et al.[25]
 
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Metadata
Title
Combination Vaccine Against Invasive Meningococcal B and Pneumococcal Infections
Potential Epidemiological and Economic Impact in The Netherlands
Authors
Dr Jasper M. Bos
Hans C. Rümke
Robert Welte
Lodewijk Spanjaard
Loek van Alphen
Maarten J. Postma
Publication date
01-02-2006
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue 2/2006
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200624020-00004

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