Economic evaluation of options for measles vaccination strategy in a hypothetical Western European country

Abstract

In this study an analysis was made of economic costs and medical effects (by cost-effectiveness and cost-benefit analysis) associated with measles vaccination in a hypothetical Western European country. We analysed ten vaccination options in terms of past and future vaccination coverage. We show that several of the proposed strategies for improving measles vaccination coverage are preferable to maintaining the existing policies, regardless of past coverage and the viewpoint of the analysis. For society, very high coverage (95%) two-dose vaccination is most optimal, irrespective of past vaccination coverage. The addition of a one-time campaign (to reduce susceptibility in (pre-)adolescent age groups) to such a high coverage two-dose vaccination programme is cost-saving to the health-care payer and to society when coverage in the past was low (< or = 70%). Even when coverage in the past was high (90%) for more than a decade, this 'maximum strategy' could be implemented at an acceptable cost to the health-care payer (incremental direct costs per discounted life-year gained < 30,000 Euros), and at net savings to society.

Health burden and economic impact of measles-related hospitalizations in Italy in 2002–2003

“…Recent studies have estimated the economic costs of measles cases and measles control in industrialized countries, mainly on the basis of various assumptions regarding measles incidence, vaccination coverage, hospitalization rates and treatment costs in different countries [11,21-24]. However, to our knowledge no nation- wide studies have been performed to directly evaluate the costs of measles-related hospitalizations on the basis of DRG rates.…”

“…It is well known that measles infection can cause serious complications and between 1.4% and 19.0% of measles cases that occur in industrialized countries require hospitalization [7-11]. Many measles-related hospitalizations were therefore expected to have occurred across Italy in 2002 and 2003.…”

A Randomized, Controlled Trial of an Aerosolized Vaccine against Measles

“…28,29 Third, if aerosolized vaccine increases the coverage of primary vaccination, this strategy could be more cost-effective than two-dose vaccination at lower levels of coverage. 30 Data are lacking to evaluate the effectiveness and cost-effectiveness of aerosolized vaccine against measles as a primary dose in children older than 12 months of age and as a second dose in children younger than 5 years of age. Data are also lacking to evaluate the effectiveness and cost-effectiveness of aerosolized vaccine containing both measles and rubella virus.…”

Effektivität, Populationseffekte und Gesundheitsökonomie der Impfungen gegen Masern und Röteln

“…Es wurde festgestellt, dass in einem Masernimpfprogramm bei einer relativ geringen 1-Dosis-Impfquote (<70%) als Ausgangslage die Steigerung der Impfquote auf 90-95% zu Kosteneinsparungen führte. Lägen die Impfquoten anfänglich jedoch bereits bei über 90%, hinge es vom jeweiligen Gesundheitssystem ab, ob eine derartige Maßnahme noch als kosteneffektiv angesehen werden würde oder nicht [8]. Für die Schweiz wurde bereits 1978 errechnet, dass sich eine generelle Masernimpfung im zweiten Lebensjahr volkswirtschaftlich "rentiert" [9].…”