PharmacoEconomics & Outcomes News | 2021
Meningococcal serogroup B vaccination: substantial benefits but not cost effective
Abstract
Routine meningococcal serogroup B (MenB) vaccination provides substantial health benefits but is not cost effective, according to a systematic review of the literature conducted by researchers from the University of Nottingham in the UK. The review was carried out to synthesise the available evidence on the cost effectiveness of MenB vaccination at global level. The review was conducted following the Preferred Reporting Items for Systematic Reviews and Metaanalysis (PRISMA) statement as well as the guidelines for reporting systematic reviews of economic evaluation from the Centre for Review and Dissemination (CRD). The literature search identified 13 studies that met the eligibility criteria. The studies were published between 2013 and 2019. All studies were conducted in high-income countries, ten in the European region, and there was one study each from Canada, Chile and the US. All studies used decision-analytical modelling. Most studies (12) assessed the cost effectiveness of routine universal MenB vaccination, whereas the study from Chile evaluated the cost effectiveness of MenB vaccination in the context of a hypothetical epidemic MenB outbreak. Routine MenB vaccination was found to reduce cases of invasive MenB disease significantly. However, at national decision-making thresholds, the intervention was not considered cost effective, largely due to the high vaccine cost and the prevailing low MenB incidence. Findings did not differ significantly with geography or vaccination strategy (infant, adolescent or combined strategies). Routine infant vaccination was considered the most effective short-term strategy, whereas combined infant and adolescent vaccination provided maximal long-term health benefits. Routine adolescent vaccination was the most cost-effective strategy compared to infant or combined strategies, but still not cost effective at commonly used thresholds. Infant strategies had the highest incremental cost-effectiveness ratios. Inclusion of herd protection resulted in more favourable incremental cost-effectiveness ratios.