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Cost-effectiveness analyses of monovalent mumps vaccination programs for Japanese children
Shu-Ling Hoshi1, Reiko Okubo2, Keiji Tabuchi3
1Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577 Japan.
Background:
The most common preventative measure against mumps is vaccination with mumps vaccine. Over 122 countries have implemented mumps vaccine routine immunization programs, mostly via Measles-Mumps-Rubella (MMR) vaccine. In Japan, the unexpectedly high incidence of aseptic meningitis caused by mumps vaccine led to the discontinuation of the MMR national vaccination program in 1993, inadvertently resulting in the re-emergence of mumps. Plans of introducing monovalent mumps vaccine into routine vaccination schedule have become one of the emerging topics in health policy that has warranted the need in evaluating its value for money.
Methods:
We conducted cost-effectiveness analyses with Markov model and calculated incremental cost-effectiveness ratios (ICERs) of two different vaccination programs (a single-dose program at one-year-old, a two-dose program with second dose uptakes at five) compared to status quo from both payers' and societal perspectives. Transition probabilities and utility weights in estimating quality-adjusted life-year (QALY), and disease treatment costs were either estimated or obtained from literature. Costs per vaccination were assumed at ¥6140 (US$58;1US$ = ¥106).
Results:
Both programs reduce disease treatment costs compared to status quo, while the reduction cannot offset vaccination cost. ICER of either program is found to be under ¥5,000,000 (US$47,170)/QALY willingness-to-pay (WTP) threshold from either perspective. Results of probabilistic sensitivity analyses expressed by net monetary benefit indicated that at the WTP threshold, the acceptability is at 92.6% for two-dose vaccination program, 0% for single-dose vaccination program, and 7.4% for current no vaccination program. Two-dose program was optimal among the alternatives. One-way sensitivity analyses revealed that proportion of mumps-related hearing loss among mumps cases and vaccine effectiveness (VE) were key variables in changing the ICERs.
Conclusion:
Routine vaccination program of single- and two-dose programs were cost-effective from both payers' and societal perspectives. Between the two, the two-dose vaccination program was observed to be more favorable.
Insights
Implementing mumps vaccination programs, particularly a two-dose regimen, is cost-effective for preventing mumps and its complications. These strategies offer significant value for money from both payer and societal viewpoints.
Area of Science:
- Public Health
- Health Economics
- Vaccinology
Background:
- Mumps prevention relies heavily on vaccination, with most countries using the Measles-Mumps-Rubella (MMR) vaccine.
- Japan's discontinuation of the MMR vaccine in 1993 due to aseptic meningitis concerns led to a resurgence of mumps.
- Evaluating the cost-effectiveness of introducing a monovalent mumps vaccine is crucial for current health policy.
Purpose of the Study:
- To assess the cost-effectiveness of single-dose and two-dose mumps vaccination programs compared to no vaccination.
- To determine the optimal vaccination strategy from both payer and societal perspectives.
Main Methods:
- Cost-effectiveness analysis using a Markov model.
- Calculation of incremental cost-effectiveness ratios (ICERs).
- Estimation of transition probabilities, quality-adjusted life-year (QALY) weights, and disease treatment costs.
Main Results:
- Both single-dose and two-dose vaccination programs reduce disease treatment costs but do not offset vaccination expenses.
- ICERs for both programs fall below the willingness-to-pay (WTP) threshold of ¥5,000,000/QALY.
- Probabilistic sensitivity analysis showed 92.6% acceptability for the two-dose program at the WTP threshold, with vaccine effectiveness and mumps-related hearing loss proportion being key variables.
Conclusions:
- Routine single- and two-dose mumps vaccination programs are cost-effective from both payer and societal perspectives.
- The two-dose vaccination program is more favorable than the single-dose program.
- These findings support the reintroduction of mumps vaccination in Japan.
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