Projected Cost-effectiveness of New Vaccines for Adolescents in the United States

Ortega-Sánchez, Ismael R.; Lee, Grace M.; Jacobs, R. Jake; Prosser, Lisa A.; Molinari, Noelle Angelique M.; Zhang, Xinzhi; Baine, William B.; McCauley, Mary M.; Miller, Ted R.

doi:10.1542/peds.2007-1115h

Cited by 30 publications

(15 citation statements)

References 53 publications

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“…Our cost-effectiveness analysis of reminders complements the literature on cost-effectiveness of adolescent vaccinations themselves. [55][56][57] One limitation to generalizability is that baseline immunization rates were lower than in some areas; benefits of the intervention could wane as rates rise. However, baseline preventive visit rates mirrored national rates.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

Szilâgyi

Albertin

Humiston

et al. 2013

Academic Pediatrics

107

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Objective-To assess the impact of a managed care-based patient reminder/recall system on immunization rates and preventive care visits among low-income adolescents.Methods-We conducted a randomized controlled trial between December 2009 and December 2010 that assigned adolescents aged 11-17 years to one of three groups: mailed letter, telephone reminders, or control. Publicly insured youths (n = 4, 115) were identified in 37 participating primary care practices. The main outcome measures were immunization rates for routine vaccines (meningococcus, pertussis, HPV) and preventive visit rates at study end.Results-Intervention and control groups were similar at baseline for demographics, immunization rates, and preventive visits. Among adolescents who were behind at the start, immunization rates at study end increased by 21% for mailed (P < .01 vs control), 17% for telephone (P < .05), and 13% for control groups. The proportion of adolescents with a preventive visit (within 12 months) was: mailed (65%; P <.01), telephone (63%; P <.05), and controls (59%). The number needed to treat for an additional fully vaccinated adolescent was 14 for mailed and 25 for telephone reminders; for an additional preventive visit, it was 17 and 29. The intervention cost $18.78 (mailed) or $16.68 (phone) per adolescent per year to deliver. The cost per additional adolescent fully vaccinated was $463.99 for mailed and $714.98 for telephone; the cost per additional adolescent receiving a preventive visit was $324.75 and $487.03.Conclusions-Managed care-based mail or telephone reminder/recall improved adolescent immunizations and preventive visits, with modest costs and modest impact.

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Section: Discussionmentioning

confidence: 99%

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

Szilâgyi

Albertin

Humiston

et al. 2013

Academic Pediatrics

107

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“…Several authors have compiled reviews of both published and unpublished evaluations of meningococcal vaccine use in developed countries, [10,11,[26][27][28] the most recent in 2008. [27] While a key objective of each review was to summarize the existing economic evidence of vaccine cost effectiveness, the overall purpose of the reviews varied somewhat.…”

Section: Literature Search and Retrievalmentioning

confidence: 99%

“…[27] While a key objective of each review was to summarize the existing economic evidence of vaccine cost effectiveness, the overall purpose of the reviews varied somewhat. The earliest review, by Getsios et al, [11] was conducted to assess the adequacy of existing cost-effectiveness evidence for meningococcal vaccine.…”

Section: Literature Search and Retrievalmentioning

confidence: 99%

Methodological Concerns with Economic Evaluations of Meningococcal Vaccines

Kauf

2010

PharmacoEconomics

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The evolution of meningococcal vaccines illustrates nicely the incremental technological process that is common to much medical innovation and particularly appropriate to economic analysis. However, the economic evaluation of vaccines is complicated by several features unique to vaccines, including the possibility of indirect (herd immunity) benefits and the shear breadth of vaccination strategies available to decision makers. As with the vaccines themselves, the modelling approaches applied to the economic evaluation of meningococcal vaccines have evolved to become increasingly complex. Despite such innovation, concerns remain about the quality of economic studies of meningococcal vaccines. This article reviews evaluations of meningococcal vaccine strategies in developed countries and provides recommendations for future work in this area. Four potentially problematic areas in the existing literature are identified - indirect costs, herd immunity, quality of life and comparison programmes - and approaches to these issues are discussed. Recommendations for reporting a 'minimum analysis profile' case are also made. Although comparisons across studies are difficult at best, recent work shows that incorporating the indirect benefits and costs of vaccination substantially improves cost effectiveness.

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“…Similar to other reviews referring to specific settings [11,12], we thought it would be interesting to critically review the economic evaluations (EEs) on the vaccine done in the countries included in the European Union (EU), comparing key assumptions and methodological choices. The main aim was to assess their potential contribution to public decision-making in a fairly homogeneous setting where HPV vaccination has been widely adopted.…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of human papilloma virus vaccination in the European Union: a critical review

Koleva¹,

Compadri²,

Padula³

et al. 2011

Intern Emerg Med

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The human papilloma virus (HPV) vaccine is a new and expensive vaccine potentially effective in the prevention of a cancer. We reviewed the economic evaluations (EEs) on the vaccine in the EU to assess their potential contribution to public decision-making in a fairly homogeneous setting where HPV vaccination has been widely adopted. A literature search on PubMed selected EEs on HPV vaccines in the EU for the period 2007-2010 using the terms "HPV vaccines" and "Costs and cost analysis." Fifteen articles were eventually selected. All studies were based on modelling techniques, either "cohort" or "dynamic transmission": three were cost utility, three cost-effectiveness, and the remainder included both. The ten studies explicitly assessing one of the two vaccines were all sponsored by their manufacturer, while the five studies unrelated to the vaccine type were funded by public agencies. Apart from two studies, utility estimates were always obtained from three US sources. Direct costs were always vaccination, diagnosis and treatment of related pathologies. Incremental cost-effectiveness ratio (ICER) results were less favourable when life years gained were valued rather than quality-adjusted life years, genital warts were excluded, and booster doses and extension of vaccination to men were included in the base-case analysis. All but one of the sponsored EEs recommend in favour of the vaccination strategy, which is dominant in one English study. The ICER results were very sensitive to discount rates, followed by duration of protection and vaccine price. At such an early stage, when the vaccines' efficacy have been demonstrated by well-designed studies, it is not possible (and not even reasonable) to wait for several years to measure their effectiveness; public decision-makers might benefit more from EEs designed to indicate sustainable prices using realistic estimates of crucial variables like coverage rates, rather than referring to a large number of assumptions in order to show acceptable cost-effectiveness.

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Projected Cost-effectiveness of New Vaccines for Adolescents in the United States

Cited by 30 publications

References 53 publications

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

Methodological Concerns with Economic Evaluations of Meningococcal Vaccines

Economic evaluation of human papilloma virus vaccination in the European Union: a critical review

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