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Assessing the economics of vaccination for Neisseria meningitidis in industrialized nations: A review and recommendations for further research

Published online by Cambridge University Press:  01 August 2004

Denis Getsios ,
Ingrid Caro ,
Wissam El-Hadi  and
Jaime J. Caro
Denis Getsios
Affiliation:
Caro Research Institute
Ingrid Caro
Affiliation:
Caro Research Institute
Wissam El-Hadi
Affiliation:
Caro Research Institute
Jaime J. Caro
Affiliation:
Caro Research Institute
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Abstract

Objectives: To review the existing health economic literature on meningococcal disease vaccination.

Methods: A Medline search for economic evaluations of vaccination programs for meningococcal disease in developed countries was conducted. All identified studies were reviewed.

Results: Nine published studies were identified examining either mass vaccination during outbreaks or routine vaccination. Although net expenses were estimated in almost all studies, the resulting cost-effectiveness ratios varied widely. Vaccination of college-age students was found to be potentially cost-effective in Australia but not in the United States. With one exception, routine vaccination of children and adolescents in Europe was predicted to be cost-effective. Many simplifying assumptions were made, and important elements were often left out, in particular the potential for reduced transmission of disease.

Conclusions: The methods used and the vaccination strategies vary widely, and results do not provide strong grounds for making conclusions as to whether vaccination is cost-effective. Furthermore, in all instances, transmission of disease, changes in population carriage rates, and outbreaks are either ignored, dealt with using very broad simplifying assumptions, or are not necessarily generalizable to other settings. The analyses provide some insight into the potential cost-effectiveness of vaccination, but more importantly, they highlight areas requiring further study. Economic evaluations based on observed outcomes from recently implemented strategies would be helpful, as would more sophisticated health economic models. The choice of vaccination strategies cannot be based on the results of existing economic analyses.

Keywords

Meningococcal diseaseNeisseria meningitidisCost-effectivenessReviewVaccines
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 20 , Issue 3 , August 2004 , pp. 280 - 288
Copyright
© 2004 Cambridge University Press

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