Cost-effectiveness of meningococcal vaccination of Norwegian teenagers with a quadrivalent ACWY conjugate vaccine

Watle, Sara Sofie Viksmoen; Næss, Lisbeth Meyer; Tunheim, Gro; Caugant, Dominique A.; Wisløff, Torbjørn

doi:10.1080/21645515.2021.1880209

Cited by 6 publications

(4 citation statements)

References 41 publications

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“…Based on experience with previous tenders for vaccines included in the Norwegian NIP, the rebate varies between 25–75%. 36 In compliance with the Norwegian guidelines for STA of pharmaceuticals, 12 the cost of administering a vaccine is calculated as the renumeration for fee-for-service per the GP Fees List Collective Agreement 2021–2022 (takst2ad) 37 multiplied by two (168 × 2 = 336 NOK/EUR 34). In line with the Norwegian guidelines for STA of pharmaceuticals, 12 an additional cost of 150 NOK (EUR 15) for a single subcutaneous injection is used per vaccine delivery.…”

Section: Methodsmentioning

confidence: 99%

Cost-utility analysis of a universal pneumococcal vaccination programme for older adults in Norway

Nymark

Berild

Lyngstad

et al. 2022

Human Vaccines & Immunotherapeutics

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The aim of this study was to establish whether the universal pneumococcal vaccination for older adults in Norway is likely to be cost-effective from the perspective of the health care provider. A decision tree model developed by the Public Health Agency of Sweden was adapted to the Norwegian setting. Two cohorts, consisting of 65-year-olds and 75-year-olds grouped into vaccinated and unvaccinated, were followed over a 5-year time horizon. In the base case, the 23-valent polysaccharide vaccine (PPV23) was used while the 13-valent pneumococcal conjugate vaccine (PCV13) was included in scenario analyses only. The costs and health benefits (measured in quality adjusted life years (QALY) gained) were compared in the two cohorts between the vaccinated and unvaccinated groups. The impact of indirect effects of the vaccine, such as herd immunity and serotype replacement, were not investigated. The relative importance of change in price was assessed by performing one-way sensitivity analyses. Under base-case assumptions, the programme for the 75-year-old cohort is expected to be dominant (cost-effective) from the health care perspective at the current maximal pharmacy retail price and at 75% vaccination coverage. In comparison, for the 65-year-old cohort the cost per QALY gained is approximately NOK 601,784 (EUR 61,281) under the base-case assumptions. A reduction in the cost of the vaccine to one quarter of its current level also brings the cost per QALY gained within the acceptable ranges in a Norwegian context for both the 65- and 75-year-old cohorts. There is no exact cost-effectiveness threshold in Norway. However, introducing a vaccination programme against pneumococcal disease for 65-year-olds in Norway is likely to fall within the acceptable range while for the 75-year-old cohort the universal programme appears to be dominant (cost-effective).

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Section: Methodsmentioning

confidence: 99%

Cost-utility analysis of a universal pneumococcal vaccination programme for older adults in Norway

Nymark

Berild

Lyngstad

et al. 2022

Human Vaccines & Immunotherapeutics

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“…Studies conducted in the Netherlands and Norway evaluated the inclusion of MCV-4 into NIP vaccination among adolescents and all concluded cost-effectiveness under a high willingness-to-pay threshold. 46 , 47 The Norwegian study in 2021 adopted a threshold of €86 thousand/QALY, which was formulated based on the local GDP per capita and higher than the threshold in the present study. This study also assumed a 50% price discount for MCV-4 included in the NIP, reducing the ICERs and contributing to the cost-effectiveness.…”

Section: Discussionmentioning

confidence: 89%

“…This study also assumed a 50% price discount for MCV-4 included in the NIP, reducing the ICERs and contributing to the cost-effectiveness. 47 Given the bargaining power of national procurement and high demand for NIP vaccines in China, the prices of non-NIP vaccines are likely to decrease after their inclusion in the NIP, leading to lower ICERs and potential cost-effectiveness. Moreover, the establishment of a national willingness-to-pay threshold in China would provide a local benchmark for economic evaluations, incorporating reference to WHO thresholds, the status of national economic development, and the importance attached to population health.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of vaccination strategies against meningococcal disease for children under nine years of age in China

Zhang,

Fang

2024

Human Vaccines & Immunotherapeutics

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Meningococcal vaccination strategies in China are intricate, including multiple vaccines targeting different serogroups. The current National Immunization Program (NIP) includes two polysaccharide vaccines for serogroups A and C (MPV-A and MPV-AC), covering limited serogroups and requiring adaptation. This study aims to evaluate the cost-effectiveness of replacing the current strategy with alternative strategies utilizing non-NIP vaccines to inform policy decisions. From a societal perspective, a decision tree-Markov model was constructed to simulate the economic and health consequences of meningococcal disease in a 2019 birth cohort with four vaccination strategies. Epidemiology, vaccine efficacy, cost, and other parameters were derived from previous studies. We conducted sensitivity analyses to assess the robustness of the findings and explored prices for non-NIP vaccines that enable cost-effective strategies. Compared to the current strategy, alternative strategies using quadrivalent polysaccharide vaccine (MPV-4), bivalent conjugate vaccine (MCV-AC), and quadrivalent conjugate vaccine (MCV-4) could avoid 91, 286, and 455 more meningococcal cases. The ICERs were estimated at approximately $250 thousand/QALY, $450 thousand/QALY, and $1.5 million/QALY, all exceeding the threshold of three times GDP per capita. The alternative strategies were not cost-effective. However, if vaccine prices were reduced to $3.9 for MPV-4, $9.9 for MCV-AC, and $12 for MCV-4, the corresponding strategy would be cost-effective. The current meningococcal vaccination strategy in China could effectively prevent the disease at a low cost, but with limited serogroup coverage. Strategies using MPV-4, MCV-AC, or MCV-4 could increase health benefits at a substantial cost, and might become cost-effective if vaccine prices decrease.

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“…Another factor that should be taken in designing and implementing vaccination programmes is the cost-effectiveness ratio. Although MenACWY is one of the most expensive vaccine [ 36 ], some studies suggest that its implementation among developed countries could be cost-effective [ 37 , 38 ]. For example, it has been estimated that vaccinating the 15–19 years old Australians with MenACWY could lead to 2058 quality adjusted life years (QALY) gained and 114 million Australian dollars of direct and indirect costs saved [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Quadrivalent Conjugate Meningococcal Vaccines: A Systematic Review and Meta-Analysis

et al. 2023

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Over the last decades, different quadrivalent antimeningococcal vaccine formulations (diphteria toxoid conjugate, MenACWY-D; tetanus toxoid conjugate, MenACWY-TT; CRM197 protein conjugate, MenACWY-CRM) have been developed. However, their availability varies, both in terms of authorized formulations and of inclusion in vaccination schedules. Furthermore, several countries include only the monovalent meningococcal C (MenC) vaccine in their immunization programmes. Finally, there is currently no updated systematic review that directly compares the MenACWY formulations. Thus, we summarized the evidence on efficacy and safety through four parallel, independent systematic literature reviews with meta-analysis which included randomized controlled trials comparing the abovementioned vaccines. A total of 16 studies have been included. In terms of efficacy, MenACWY-TT outperformed MenACWY-D and MenACWY-CRM for A, W-135, and Y serogroups, while no significant difference was found for serogroup C. Furthermore, we did not find significant differences in efficacy between MenC and MenACWY-TT. Regarding the safety, we were able to perform a quantitative analysis only between MenACWY-TT and MenC, finding no significant differences. Similarly, among the different MenACWY formulations no relevant differences were identified. These findings suggest that MenACWY-TT could be preferable to other formulations to improve current vaccination programs and to better develop future immunization policies.

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Cost-effectiveness of meningococcal vaccination of Norwegian teenagers with a quadrivalent ACWY conjugate vaccine

Cited by 6 publications

References 41 publications

Cost-utility analysis of a universal pneumococcal vaccination programme for older adults in Norway

Cost-utility analysis of a universal pneumococcal vaccination programme for older adults in Norway

Cost-effectiveness analysis of vaccination strategies against meningococcal disease for children under nine years of age in China

Efficacy and Safety of Quadrivalent Conjugate Meningococcal Vaccines: A Systematic Review and Meta-Analysis

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