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Public Health Impact and Cost-Effectiveness Analysis of 4-Component Meningococcal Serotype B Vaccination for Infants
Gérard de Pouvourville1, Manon Breau-Brunel2, Véronique Loncle-Provot3
1Essec Business School, Cergy-Pontoise, France.
Background And Objectives:
In France, meningococcal serogroup B (MenB) is the most common serogroup causing invasive meningococcal disease (IMD) in infants and young children. Our objective was to illustrate the impact of model choices on health outcomes and the cost-effectiveness of infant vaccination with the multicomponent meningococcal serogroup B vaccine (4CMenB) versus no vaccine in France.
Methods:
A previously published dynamic transmission-based cost-effectiveness model was adapted for the French context using updated, French-specific demographic, epidemiological, and cost data. IMD incidence and long-term sequelae were derived through analysis of French healthcare and surveillance databases. A collective perspective over a 100-year time horizon was adopted, with a discount rate of 2.5%, reduced to 1.5% after the first 30 years. Deterministic and probabilistic sensitivity and scenario analyses were performed.
Results:
In the base case analysis, infant vaccination with 4CMenB avoided 3101 MenB IMD cases in infants aged < 1 year (- 54%) and 6845 cases in all age groups (- 21%). The estimated incremental cost-effectiveness ratio was €316,272/quality-adjusted life-year (QALY) but was highly sensitive to the types of sequelae included, MenB incidence, vaccine effectiveness parameters, and consideration of life-expectancy in IMD survivors (range: €65,272/QALY to €493,218/QALY).
Conclusions:
Using economic models compliant with French methodology guidelines, 4CMenB does not seem cost-effective; however, results are sensitive to model choices and 4CMenB immunization is an effective strategy to prevent MenB IMD cases and to improve quality of life and economic burden associated with MenB IMD treatment, especially with regard to long-term sequelae.
Insights
Infant vaccination with the 4CMenB vaccine in France significantly reduces meningococcal serogroup B invasive disease cases. However, its cost-effectiveness is sensitive to model choices, highlighting the need for careful consideration of long-term outcomes.
Area of Science:
- * Public Health
- * Epidemiology
- * Health Economics
Background:
- * Meningococcal serogroup B (MenB) is the leading cause of invasive meningococcal disease (IMD) in French infants and young children.
- * The multicomponent meningococcal serogroup B vaccine (4CMenB) offers a potential preventive strategy.
Purpose of the Study:
- * To assess the impact of model choices on health outcomes.
- * To evaluate the cost-effectiveness of infant vaccination with 4CMenB compared to no vaccination in France.
Main Methods:
- * Adaptation of a dynamic transmission-based cost-effectiveness model using French demographic, epidemiological, and cost data.
- * Analysis of French healthcare and surveillance databases for IMD incidence and long-term sequelae.
- * 100-year time horizon with specific discount rates and sensitivity analyses.
Main Results:
- * Infant vaccination with 4CMenB avoided 3101 cases in infants (<1 year) and 6845 cases overall.
- * The base case incremental cost-effectiveness ratio was €316,272/QALY, with a wide range (€65,272–€493,218/QALY) based on model parameters.
Conclusions:
- * While not appearing cost-effective under standard French guidelines, 4CMenB is effective in preventing MenB IMD.
- * Results are highly sensitive to model assumptions, particularly regarding sequelae and life expectancy.
- * Vaccination improves quality of life and reduces the economic burden of MenB IMD.
