Economic evaluation of varicella vaccination in Spain—Results from a dynamic model

• Published in: Vaccine Vol. 24; no. 47; pp. 6980 - 6989
• Main Authors: Lenne, X., Diez Domingo, J., Gil, A., Ridao, M., Lluch, J.A., Dervaux, B.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 17-11-2006; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Applied microbiology; Biological and medical sciences; Chicken pox; Chickenpox - economics; Chickenpox - epidemiology; Chickenpox - prevention & control; Child; Child, Preschool; Cost Savings; Cost-benefit; Costs and Cost Analysis; Economic impact; Economics; Economics and Finance; Fatalities; Female; Fundamental and applied biological sciences. Psychology; Health care; Human viral diseases; Humanities and Social Sciences; Humans; Immunity, Herd - immunology; Immunology; Infant; Infectious diseases; Life Sciences; Male; Mass Vaccination - economics; Medical sciences; Microbiology; Middle Aged; Models, Immunological; Models, Statistical; Morbidity; Sensitivity analysis; Smallpox; Spain; Spain - epidemiology; Vaccination; Vaccines; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies (general aspects); Vaccinology; Varicella; Viral diseases; Viral diseases with cutaneous or mucosal lesions and viral diseases of the eye; Europe; Spain; Italy; France; United States > US; Germany; Varicella; Cost-benefit; Vaccination; Spain; Infection; Economic analysis; Skin disease; Viral disease; Models
• ISSN: 0264-410X; 1873-2518; 0264-410X
• DOI: 10.1016/j.vaccine.2006.04.051

Varicella is a universal childhood disease in Spain, causing approximately 400,000 cases, 1500 hospitalizations and 15 deaths every year. The aim of this study is to determine the economic impact of childhood varicella vaccination on the burden of disease and associated costs by using a dynamic model. The analysis is based on the varicella transmission model developed by Halloran and adapted to the Spanish context. Cost data (€, 2004) were derived from previous studies and official tariffs. Two vaccination scenarios were analysed: (1) routine vaccination program for children aged 1–2 years, and (2) routine vaccination program for children aged 1–2 years completed by a catch-up program during the first year of vaccine marketing for children aged 2–11 years. The analysis considers that a similar coverage rate to the MMR one would be achieved (97.15%). A societal perspective, including direct and indirect costs, and a health care payor perspective were adopted. A probabilistic sensitivity analysis was performed. A routine vaccination program has a positive impact on varicella-related morbidity: the number of varicella cases is estimated to be reduced by 89%, and 1230 hospitalizations are prevented. From the societal perspective, scenario (1) is cost-saving whether or not indirect costs are considered (−51 and −4%, respectively). From the Health Care System the strategy is cost-effective, with a cost-effectiveness ratio estimated at €3982 per life-year gained, although it leads to a small increase in the costs. Considering the impact of vaccination on morbidity and costs, a routine childhood vaccination program against varicella is worth while in Spain without taking into account the potential impact on HZ.