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PharmacoEconomics

, Volume 23, Issue 9, pp 855–874 | Cite as

The role of economic evaluation in vaccine decision making

Focus on meningococcal group C conjugate vaccine
  • Robert Welte
  • Caroline L. Trotter
  • W. John Edmunds
  • Maarten J. Postma
  • Philippe Beutels
Review Article

Abstract

In recent years, several countries have experienced increases in the incidence of serogroup C meningococcal disease. It can be controlled with older polysaccharide vaccines and particularly the recently developed conjugate vaccines. For 21 developed countries, we investigated the role that economic evaluation played in the decision to introduce the conjugate vaccine into either the routine childhood vaccination schedule, as a mass vaccination ‘catch-up’ campaign or not at all. A literature review was performed and experts from these countries were contacted.

For six countries, we identified published economic evaluations for meningococcal C conjugate vaccination. In four of them (Australia, Canada [Quebec], The Netherlands and the UK) the analyses were performed before a decision about the use of the conjugate vaccine was made. In all of these countries, the economic evaluation offered guidance as to the most efficient way to add the conjugate vaccine to the routine infant immunisation schedule and, in three countries, this advice was adopted by decision makers. In Portugal and Switzerland, initial vaccination decisions were made without the economic evaluations that are influencing current decision making. Of the countries without economic evaluations, six implemented vaccination programmes. Overall, there was a positive correlation between the reported incidence of meningococcal C disease and (a) the decision to vaccinate and (b) performing an economic evaluation.

All economic evaluations were modelling studies. The reported cost-effectiveness ratios were sensitive to the age of vaccination, the future meningococcal incidence, vaccine price and some methodological characteristics that varied widely between studies making direct comparisons difficult.

In conclusion, in almost all countries where economic evaluations for meningococcal C conjugate vaccinations have been conducted, their results had an important role in the decision-making process. However, in most countries with strongly increasing meningococcal incidence, public health considerations took precedence. In order to improve the international comparability of such studies, firmer national and international modelling guidelines and better adherence to such guidelines seem necessary.

Keywords

Economic Evaluation Vaccination Programme Conjugate Vaccine Meningococcal Disease Vaccination Campaign 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We would like to thank: the participants of EuMenNet and European Union Invasive Bacterial Infections Surveillance Network (EU-IBIS):[15] S. Heuberger (Austria); S. Samuelsson (Denmark); M.-K. Taha (France); U. Volgel (Germany); G. Tzanakaki (Greece); M. Cafferkey and D. O’Flanagan (Ireland); R. Dagan (Israel); P. Mastrantonio (Italy); P. Huberty-Krau (Luxembourg); M. Muscat (Malta); R. Cano Portero (Spain); and P. Olcen (Sweden) who responded to our enquiries. We would also like to thank: P. De Wals (Laval University, Quebec); H. Jaccard Ruedin (Swiss Federal Office of Public Health);[62] Infarmed (Lisbon, Portugal) and N. Silverio (Wyeth Lederle Portugal)[22] for supplying us with information.

Caroline Trotter is currently supported by the EU-MenNet project, DG RESEARCH, Q2K2-LT-2001-01436. The authors have no conflicts of interest that are directly related to the content of this paper.

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Copyright information

© Adis Data Information BV 2005

Authors and Affiliations

  • Robert Welte
    • 1
  • Caroline L. Trotter
    • 2
  • W. John Edmunds
    • 2
  • Maarten J. Postma
    • 3
  • Philippe Beutels
    • 4
    • 5
    • 6
  1. 1.Institute of Health Economics and Health Care ManagementGSF-National Research Center for Environment and HealthNeuherbergGermany
  2. 2.Centre for InfectionsHealth Protection AgencyLondonUK
  3. 3.Groningen University Institute for Drug Exploration/Groningen Research Institute for PharmacyUniversity of GroningenGroningenThe Netherlands
  4. 4.National Centre for Immunisation Research and SurveillanceUniversity of SydneySydneyAustralia
  5. 5.Centre for Health Economics Research and Evaluation University of TechnologySydneyAustralia
  6. 6.Centre for the Evaluation of VaccinationUniversity of AntwerpAntwerpBelgium

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