Economic evaluation of varicella vaccination in Swiss children and adolescents

Abstract

This study explores the effects of three different 2-dose varicella zoster virus (VZV) vaccination strategies in Switzerland. The EVITA model was used to assess clinical benefits and costs of strategies (1) vaccination of 11-15 year old adolescents with a negative or uncertain history for chickenpox, (2) universal vaccination of toddlers at age 1 to 2 years, and (3) strategy 2 plus catch-up vaccination of 11-15 year old susceptible adolescents. The cost-effectiveness analysis compares strategies 2 and 3 versus strategy 1 (current vaccination policy in Switzerland). Probabilities for clinical outcomes and medical resource utilization were derived from a real-world survey among Swiss pediatricians and general practitioners including 236 individuals with VZV infection, published information on varicella complications, and expert opinion. Costs of medical resource utilization represent official Swiss medical tariffs. The model predicts both universal childhood vaccination strategies to be more effective in reducing varicella disease burden compared to strategy 1. Economically, both universal childhood vaccination strategies with or without catch-up result in net savings from the societal perspective reflected by a benefit cost ratio (BCR) of 1.22 or 1.29, respectively. In contrast, the model predicts net costs from the payer perspective (BCR of 0.27 and 0.30, respectively). These economic findings are comparable to those reported from other similar evaluations. However, due to the recent recommendation for using a 2-dose varicella vaccination schedule, our economic results for Switzerland are somewhat less favorable than those for other country analyses in which a less expensive 1-dose vaccination regimen for toddlers has been studied.

Economic evaluation of Varicella vaccination: results of a systematic review

“…The review evidenced that the quality score of the studies varied over years, even in the same year and in analyses conducted by the same authors: Scuffham et al 22 vs. Scuffham et al 23 26,27,31,34,38,39,41,42,44 The results of Scuffham et al 22,23 varied in different environments: in 1999 they affirmed that the introduction of varicella program is cost saving for the New Zealand society, while in Australia, the childhood vaccine program is still preferred but has greater costs than the no vaccination program. Furthermore, according to Getsios et al, 28 the childhood vaccination program is not cost-effective for the Canadian healthcare system.…”

Varicella vaccination - the global experience

“…Alternatively, the addition of a second dose provides protection against all severities [25]. The economics of implementing one- or two-dose schedules have been widely debated [20,26,27], but national choices will ultimately depend on whether their priorities are varicella elimination or prevention of severe disease. Interestingly, a recent modeling study from Italy demonstrated that out of coverage, efficacy, number of doses, or dosing interval, high coverage is the critical success factor [28].…”

Prospective surveillance of varicella-zoster virus infections in an out-patient setting in Switzerland

“…22 Not surprisingly, most cases occurred in young children who are known to be mainly affected by varicella and median age of patients (5 years) was the same as in a similar study from Germany. 21,23 It should be noted that this study was not population based but observational which means that the age distribution of our patients may not accurately reflect the occurrence of varicella in the general population. This may explain the relatively high proportion (76%) of cases in children up to 6 years of age in this study compared to seroprevalence rates and age distribution of hospitalized cases (with approximately 50% up to 6 years of age) obtained in previous studies in Switzerland by members of our group.…”