Cost-effectiveness of tick-borne encephalitis vaccination in Slovenian adults

Slovenia is an endemic country with a high incidence rate of tick-borne encephalitis (TBE) and low vaccination coverage. TBE causes high costs for the health care insurances as well as the society due to hospitalization and frequent long term or permanent neurological sequelae. Vaccination is effective and a safe prophylaxis against TBE.

The purpose of this study was to evaluate the incremental cost-effectiveness ratio (ICER) between vaccination and no vaccination in Slovenia. The results are shown as cost per quality-adjusted life year (QALY) gained from the view of the health care payer and the society.

Based on the natural course of the disease, the Markov model was used for comparing the economic and health outcomes of vaccinated and unvaccinated groups from 18 to 80 years of age.

The incremental cost-effectiveness ratio from the current Slovenian vaccination programme for FSME-Immun(®) compared to no vaccination amounts to € 15,128 per QALY gained and for Encepur(®) € 20,099 per QALY gained from the view of the health care payer. From the view of the society vaccination is cost saving, mainly due to avoiding the high indirect costs.

According to the cost-effectiveness threshold as proposed by the Slovenian Health Council, the current Slovenian vaccination programme against TBE is cost-effective from the health care payer's perspective and also economical from the society's perspective.