http://bmj.com/cgi/content/abstract/324/7341/809
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which this article appears: Other
Health Policy Drugs:
immunological products and vaccines Drugs:
infections Health
education (including prevention and promotion) Health
Economics |
Caroline L Trotter
a Immunisation Division, PHLS Communicable Disease Surveillance Centre, London NW9 5EQ, b Department of Economics, City University, London EC1V 0HB
Correspondence to: C Trotter
ctrotter@phls.org.uk
Objectives: To assess the cost effectiveness of a meningococcal
serogroup C conjugate vaccination campaign in 0-17 year olds.
Design: Cost effectiveness analysis from the perspective of
the healthcare provider.
Setting: England and Wales.
Main outcome measure: Cost per life year saved.
Results: In 1998-9, immediately before the introduction of
meningococcal C vaccination, the burden of serogroup C disease was
considerable, with an estimated 1137 cases in people aged 0-17 years
and at least 72 deaths. The vaccination campaign is estimated to have
cost between £126m ($180m, 
207m) and £241m
($343m, 395m), depending on the price of the vaccine. Under
base case assumptions the cost per life year saved from the
vaccination campaign is estimated to be £6259. School based
vaccination was more cost effective than general practice based
vaccination because of lower delivery costs. Immunisation of infants
aged under 1 year was the least cost effective component of the
campaign because, although this maximises the life years gained, the
three dose schedule required is more expensive than other methods of
delivery. Estimates of the cost per life year saved were sensitive to
assumptions on the future incidence of disease and the case fatality
ratio.
Conclusions: Meningococcal C vaccination is likely to be more
cost effective in all age groups when the incidence of disease is
high. It is also more cost effective when given to children aged
1-4 (by general practitioners) and to children and young people aged
5-17 years at school than when administered to infants under
12 months of age or young people aged 16-17 years who are not at
school.
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What is already known on this topic In November 1999 the United Kingdom was the first country to introduce mass vaccination against group C meningococcal disease There are no published economic evaluations of the vaccination campaign What this study adds School based vaccination is more cost effective than routine vaccination of infants because delivery costs are lower and fewer doses are required |
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