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Cost-effectiveness analysis of a pertussis vaccination programme for Japan considering intergenerational infection

Tomoya Itatani1, Sachiko Shimizu, Maya Iwasa

  • 1Department of Total Health Promotion Science, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan. itatani@sahs.med.osaka-u.ac.jp

Vaccine
|April 11, 2013
PubMed

Insights

Adolescent pertussis vaccination programs are not cost-effective. However, one-time adolescent diphtheria-tetanus-acellular pertussis (DTaP) vaccination becomes cost-effective when considering intergenerational infection, highlighting the need for accurate pertussis incidence data.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Economics

Background:

  • Pertussis (whooping cough) incidence is rising in adolescents and adults, with sporadic outbreaks in Japan.
  • Intergenerational transmission of pertussis from adolescents/adults to infants is a significant concern.

Purpose of the Study:

  • To evaluate the cost-effectiveness of alternative adolescent pertussis vaccination programs compared to the conventional diphtheria-tetanus (DT) vaccine.
  • To incorporate the risk of intergenerational pertussis infection into the analysis.

Main Methods:

  • A state-transition Markov model was used to assess four vaccination strategies: DT, adolescent DT-acellular pertussis (DTaP), DTaP with booster, and DTaP with parental vaccination.
  • The model estimated costs, life expectancy, quality-adjusted life expectancy, BCR, and ICER from a societal perspective.
  • Intergenerational infection from adolescents/adults to infants was factored into the model.

Main Results:

  • At an incidence of 25 per 100,000, the incremental cost-effectiveness ratios (ICERs) for DTaP and additional DTaP for parents were 3,576,072 JPY and 240,055,273 JPY, respectively, when intergenerational transmission was considered.
  • The DTaP with booster strategy was dominated, indicating it was less cost-effective than other options.

Conclusions:

  • Currently, alternative pertussis vaccination programs are not cost-effective.
  • One-time adolescent DTaP vaccination demonstrates cost-effectiveness when intergenerational infection is considered.
  • Accurate pertussis incidence reporting is crucial, as it significantly impacts cost-effectiveness analysis outcomes.
Abstract

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