Table 7.
Cost-effectiveness and cost-utility analyses of vaccination programs in the general population
| First author [Reference] | Chapalain [[35]] | Kandola [[36]] | Hudeckova [[37]] | Zhou [[38]] | Lugner [[39]] |
|---|---|---|---|---|---|
| Country |
France |
Guyana |
Slovakia |
USA |
Netherlands |
| Year |
1978 |
1998 |
2001 |
2004 |
2010 |
| WB income group |
High |
Upper-middle |
High |
High |
High |
| Comparators |
1. Vaccinate 13-yr-olds and women |
1. Rubella eradication campaign |
1. National vaccination campaign |
1. Rubella vaccination program |
1. Screen and vaccinate all unvaccinated in LVR |
| |
2. No vaccination |
2. No campaign |
2. No campaign |
2. No vaccination program |
2. Screen and vaccinate all pregnant in LVR |
| |
|
|
|
|
3. Screen and vaccinate all unvaccinated in NL |
| Perspective |
Payer* |
NR |
Payer |
Societal |
Payer |
| Cost components measured |
Vaccination; specialist training; research; antenatal supervision; improvement of obstetric care; intensive care |
NR |
NR** |
Vaccination; OP care; hospitalization; institutional care; special care; Indirect (premature mortality, disability, missed work) |
Vaccination; screening; healthcare costs |
| Method of cost estimation |
Top-down costing |
NR |
NR** |
Micro-costing; Human capital approach (indirect costs) |
Micro-costing |
| Time period for costs and benefits |
15 years |
5 years |
NR** |
40 years |
16 years |
| Discounting (Rate) |
Yes (NR) |
NR |
NR** |
Yes (3%) |
Yes (4%) |
| Outcomes |
Mortality; lives saved |
CRS cases prevented |
Rubella cases prevented |
Cases prevented; lives saved |
QALYs |
| Method of outcome measurement |
Primary analysis of program data |
NR |
NR** |
Decision model |
Model-based |
| Results—ICER (2012 US$/Outcome) |
$20,474/Life saved |
$3,335/CRS case prevented |
$313/Case prevented |
Vaccination program was dominant |
1 dominated 2; the ICER comparing 3 to 1 was $114,575/QALY gained |
| Stated conclusion |
The immunization program was cost-effective |
Rubella eradication is highly cost-effective |
National MMR immunization program was cost-effective |
Two-dose MMR vaccination program is cost-effective |
Screening and vaccinating all unvaccinated women is the most cost-effective |
| QHES score |
30 |
NS |
NS |
93 |
62 |
| Sponsor | NR | NR | NR | CDC | NL CIDC |
*Not explicitly reported but inferred **Article in Slovak.
WB, World Bank; NR, Not Reported; NS, Not Scored; OP, Out Patient; LVR, Low vaccination coverage regions; NL, Netherlands; CDC, US Centers for Disease Control and Prevention; CIDC, Center for Infectious Disease Control; QALYs, Quality-Adjusted Life-Years.