Cost-Effectiveness Analysis of Routine Immunization for Varicella in Japan

Sugawara, Tamie; Ohkusa, Yasushi; Oikawa, Kaoru; Haneda, Noriyuki; Kikuchi, Kiyoshi; Kato, Fumihide; Yamaguchi, Seiji; Okabe, Nobuhiko

doi:10.11150/kansenshogakuzasshi1970.80.212

Cited by 10 publications

(5 citation statements)

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“…After complementing some of the data through telephone interviews, direct costs and indirect costs were analyzed following the framework of analysis published by Ohkusa et al [12] and Sugawara et al [13]. Finally, nationwide costs and BCR were estimated based on a static mathematical model of measles transmission [14].…”

Section: Methodsmentioning

confidence: 99%

“…We used a static model, as such we did not consider the adjustment period of gradual herd immunity increase and final measles epidemic control. Regarding the framework of the analysis, for the cost-benefit analysis of influenza vaccination we followed the methodology published by Ohkusa et.al [12] and for the cost-effectiveness analysis of routine immunization for varicella we followed the framework of Sugawara et al [13]. …”

Section: Methodsmentioning

confidence: 99%

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The economic disease burden of measles in Japan and a benefit cost analysis of vaccination, a retrospective study

Takahashi

Ohkusa

Kim

2011

BMC Health Serv Res

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BackgroundDuring 1999-2003, Japan experienced a series of measles epidemics, and in Action Plans to Control Measles and the Future Problems, it was proposed that infants be immunized soon after their one-year birthday.In this study, we attempted to estimate the nationwide economic disease burden of measles based on clinical data and the economic effectiveness of this proposal using the benefit cost ratio.MethodsOur survey target was measles patients treated at Chiba-Nishi general hospital from January 1999 to September 2001. Two hundred ninety-one cases were extracted from the database. The survey team composed of 3 pediatricians and 1 physician from Chiba-Nishi general hospital examined patient files and obtained additional information by telephone interview.We analyzed data based on a static model, which assumed that the number of measles patients would be zero after 100% coverage of single-antigen measles vaccine.Costs were defined as the direct cost for measles treatment, vaccination and transportation and the indirect cost of workdays lost due to the nursing of patients, hospital visits for vaccination or nursing due to adverse reactions. Benefits were defined as savings on direct and indirect costs. Based on these definitions, we estimated the nationwide costs of treatment and vaccination.ResultsUsing our static model, the nationwide total cost for measles treatment was estimated to be US$ 404 million, while the vaccination cost was US$165 million. The benefit cost ratio of the base case was 2.48 and ranged from 2.21 to 4.97 with sensitivity analysis.ConclusionsAlthough the model has some limitations, we conclude that the policy of immunizing infants soon after their one-year birthday is economically effective.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The economic disease burden of measles in Japan and a benefit cost analysis of vaccination, a retrospective study

Takahashi

Ohkusa

Kim

2011

BMC Health Serv Res

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“…Varicella vaccination is shown to be cost-effective in many studies ( 16 ), including a previous Japanese study ( 3 ) and the current study. Therefore, increasing vaccine coverage eventually reduces overall costs to the government, even if the government pays all costs of the vaccine.…”

Section: Discussionmentioning

confidence: 57%

“…Needless to say, medical costs associated with varicella infection are a huge burden. The total annual cost associated with varicella is estimated to be JPY 52.2 billion ( 3 ). Antiviral drugs are effective for shortening the duration of the disease ( 4 ) and are used in many cases in Japan, even though the patients have no risk of being severe cases, which induces higher cost.…”

Section: Introductionmentioning

confidence: 99%

Impact of Subsidies and Socioeconomic Status on Varicella Vaccination in Greater Tokyo, Japan

Nagaoka¹,

Fujiwara²

2016

Front. Pediatr.

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BackgroundAlthough the control of varicella outbreaks is an important health issue, cost could present a major barrier for vaccination. The aim of this study is to investigate the association of vaccine subsidies and caregivers’ socioeconomic status with varicella vaccine coverage of their children in Greater Tokyo, Japan, before the period that varicella vaccination was included in routine immunization program.MethodsParticipants were recruited from two different cities. In Chiba city, parents of 18-month-old infants (N = 378) undergoing a medical examination in July 2013 were recruited at a clinic where no subsidy for varicella immunization was provided. In Nishitokyo city, parents of 24- to 30-month-old children (N = 315) undergoing a health checkup in July and August 2013 were recruited at a clinic where a partial subsidy was provided. The association between household income and varicella immunization was investigated by multivariate logistic regression stratified by city.ResultsVaccine coverage was 61.0% in Chiba city and 73.3% in Nishitokyo city. In Chiba city, odds ratios of middle and high household income for varicella immunization were 4.22 [95% confidence interval (CI): 1.65–10.7] and 5.94 (95% CI: 1.89–18.6), respectively, compared to low household income. However, household income was not associated with varicella vaccination in Nishitokyo city. Neither working status nor education was associated with vaccination in both cities.ConclusionWhile household income was associated with high vaccine coverage in the city with no vaccine subsidy, this association was not observed in the city where the subsidy was given, which suggests that cost is a barrier for varicella immunization. Thus, in countries where varicella vaccination is not included in routine immunization programs, introducing subsidies nationwide or routine immunization programs for varicella vaccination would be an important approach to eliminate inequality in vaccine coverage.

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“…Therefore, it was presumed to be an appropriate measure for severity. Nevertheless, if we were to use some information about the number of rashes, unlike the present study [7,8], then the number of rashes would be a more appropriate measure of severity.…”

Section: Discussionmentioning

confidence: 96%

Varicella outbreak at a nursery school under routine immunization

Sakaue¹,

Sugawara

Sugisita

et al. 2021

Preprint

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Background and objective: In Japan, routine administration of two-dose immunization for varicella to one-year-old children was introduced in October, 2014. The objective of this study was measurement of the effectiveness of routine two-dose immunization for varicella to onset and assessment of severity in a nursery school setting. Method: The study period extended from the beginning of April, 2017 through March, 2018. The study area was Nursery school B in a city A. Subjects were 120 children in all. We analyzed vaccine efficacy (VE) as an observational study and assessed severity using Fisher exact test. We also assessed VE for severity using linear regression. Severity was defined as the length of school absence attributable to varicella infection. Results: For one dose or more, VE was 48.1% for all ages and 49.2% among children three years old and older. No significant VE was found. Vaccination using one dose or more can reduce severity significantly. Discussion and conclusion: Low VE was found in a nursery school setting, although results were not significant. VE for severity was confirmed, but a second dose might not reduce severity.

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Cost-Effectiveness Analysis of Routine Immunization for Varicella in Japan

Cited by 10 publications

References 0 publications

The economic disease burden of measles in Japan and a benefit cost analysis of vaccination, a retrospective study

The economic disease burden of measles in Japan and a benefit cost analysis of vaccination, a retrospective study

Impact of Subsidies and Socioeconomic Status on Varicella Vaccination in Greater Tokyo, Japan

Varicella outbreak at a nursery school under routine immunization

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