Health economics of a hexavalent meningococcal outer-membrane vesicle vaccine in children:potential impact of introduction in the Dutch vaccination program

The cost-effectiveness of universal vaccination of infants with a new hexavalent meningococcal B outer-membrane vesicle vaccine is projected for The Netherlands by applying decision analysis. The societal perspective is taken and direct and productivity costs (friction costs method) are considered. Future costs and effects are discounted at 4% (base year 1998).In this simulation model, vaccination would prevent 19 deaths and eight cases with severe long-term sequelae per year, rendering 526 additional quality adjusted life years (QALYs) per year. Yearly costs of acute phase of illness due to meningococcal infections in children are estimated at Euro 1,426,634, while the future costs due to sequelae are estimated at Euro 3,801,121 per year. Of all these costs, the vaccination program could prevent Euro 3,334,052 per year. The program costs of meningococcal vaccination are estimated at Euro 11,601,356, resulting in a cost-effectiveness ratio (CER) of Euro 15,721 per QALY. These results are sensitive to the vaccine dose price (conservatively Euro 10), efficacy, and coverage of meningococcal sero-subtypes. (C) 2001 Elsevier Science Ltd. All rights reserved.