Received 23 October 2001; received in revised form 1 August 2002; accepted 19
August 2002
Abstract
This study explores the economic value of a routine varicella vaccination
program for Germany. An age-structured decision analytic model was used to
assess the benefits, costs and cost-effectiveness of an immunization program for
a period of 30 years. Three interventions were compared with no vaccination:
universal vaccination of around 15 months old healthy children, vaccination of
susceptible adolescents (11-12 years of age), and the combined strategy. The
analysis was conducted from both the societal perspective and the payers', i.e.
sickness funds, perspective. Input data were mainly derived from a retrospective
survey (analyzed were1334 patient records) and from a seroprevalence study (n=4602
sera). Using a coverage rate of 85% and a vaccine efficacy rate of 86% routine
children vaccination could prevent around 611,000 varicella cases and over 4700
major complications per year. Average yearly cost savings for the society are
51.3 million Euro. The benefit-cost ratio (BCR) is 4.12. From the third-party
payer's perspective, the BCR is 1.75 which is a consequence of significant
reimbursement of parent's lost earnings by German sickness funds. The adolescent
vaccination strategy has a favorable BCR ratio of 8.44 from the societal
perspective, but clearly inferior medical effects. The combined vaccination
strategy showed similar results as the children strategy. Routine childhood
varicella vaccination appears to be a highly efficient strategy to reduce the
burden of varicella and results in significant savings for both the society and
the payers.
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"