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© Perrine Bomme, Guillaume Duménil, Jean-Marc Panaud.
Coloured scanning electron micrograph (SEM) of Neisseria meningitidis on epithelial cells
Publication : Vaccine

Epidemiological impact and cost-effectiveness of introducing vaccination against serogroup B meningococcal disease in France

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Vaccine - 19 Mar 2016

Lecocq H, Parent du Châtelet I, Taha MK, Lévy-Bruhl D, Dervaux B

Link to Pubmed [PMID] – 27002504

Vaccine 2016 Apr;34(19):2240-50

INTRODUCTION: Despite its low incidence in France, invasive serogroup B meningococcal disease remains a public health concern. A new vaccine against the disease, Bexsero(®), has been licensed in the EU. We studied the epidemiological impact and cost-effectiveness of routine vaccination using Bexsero(®) in order to inform the decision-making process regarding its potential inclusion in the vaccination schedule.

METHODS: A multi-generational Markov model was used. Time horizon was set to 100 years. Five vaccination strategies were evaluated: infants at 3, 5, 6 and 13 months, toddlers at 13, 15 and 27 months and adolescents at 15 years provided 2 doses one month apart. A booster dose at 15 years old and a catch-up for 15 years old subjects during the first 15 years of the programme were added to the infant and toddler strategies. Costs per QALY gained were computed from a restricted societal perspective including direct costs only. Herd immunity was simulated in an alternative base-case scenario and sensitivity analyses.

RESULTS: In the base-case analysis without herd immunity and with all cohorts vaccinated, at € 40 per vaccine dose, routine infant vaccination would provide the lowest cost per QALY gained (€ 380,973) despite only preventing 18% of cases. Under the assumption of herd immunity, the adolescent vaccination would provide the lowest cost per QALY gained (€ 135,902) preventing 24% of cases. Infant vaccination with a late booster and catch-up would prevent 51% of cases with a cost of € 188,511 per QALY gained.

CONCLUSIONS: Given current meningococcal epidemiology in France and the available data on the protection provided by Bexsero(®), our modelling work showed that routine vaccination against serogroup B meningococcal disease is not cost-effective.

https://www.ncbi.nlm.nih.gov/pubmed/27002504