[Economic evaluation of the introduction of 4CMenB (Bexsero®) in the national vaccine schedule in Spain].

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ID: 69148
2019
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Abstract
Bexsero® (4CMenB), meningococcal B vaccine, was licensed in Europe in 2013. In Spain, despite MenB being the most frequent cause of invasive meningococcal disease (IMD), Bexsero® is recommended and financed for patients at increased risk of IMD but is not financed by the NHS in the routine vaccination schedule.to evaluate the cost-utility, epidemiological impact, and total costs of the introduction of 4CMenB into the vaccination schedule to help inform vaccine policy in Spain.We adapted a cost-utility analysis, a probabilistic decision-tree, to Spain. A cohort of new-born infants in 2015 was modelled with two dosages, using two different strategies: routine vaccination schedule with 4CMenB and non-vaccination. Costs were measured from a payer perspective and benefits were calculated in quality-adjusted life years (QALYs). A Monte Carlo analysis and 32 scenarios were performed to assess the robustness and the uncertainty of our results.With the 3+1 dosage, routine vaccination prevented 54% of cases and deaths and an incremental cost-utility ratio (ICUR) of 351.389 €/QALY (95% confidence interval [95%CI]: 265,193-538,428) was estimated. The 2+1 dosage prevented 50% of cases and deaths, with an ICUR of 278.556 €/QALY (95%CI: 210,285-430,122).Given the current incidence of invasive meningococcal disease in Spain and the information available from 4CMenB, our model shows that routine vaccination is not cost-effective at the current price. Only with a vaccine price of 1.45 € for the 3+1 schedule or 3.37 € for the 2+1 schedule could it be recommended based on efficiency criteria.
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Authors Rafael Ruiz-Montero, David Epstein, Bernardo Guzmán Herrador, Jaime Espín Balbino
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Journal gaceta sanitaria
Year 2019
DOI
S0213-9111(19)30217-1
URL
Keywords
child infant spain preschool cost-benefit analysis análisis de costo-beneficio españa lactantes mass vaccination meningococcal vaccines neisseria meningitidis serogroup b neisseria meningitidis serogrupo b preescolares vacunación masiva vacunas meningocócicas

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