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Cost-effectiveness of adult pertussis vaccination in Germany.
Vaccine. 2008 Jul 04; 26(29-30):3673-9.V

Abstract

BACKGROUND

The incidence of pertussis in adults is high despite good childhood vaccination coverage. An adult formulation of an acellular pertussis vaccine is licensed and available for use in Germany.

OBJECTIVE

To evaluate the potential health benefits, risks, costs and cost-effectiveness of routine pertussis vaccination programs for German adults.

METHODS

A Markov model was used to simulate health states and immunity levels associated with pertussis disease and vaccination. The following strategies were evaluated: (1) no adult pertussis vaccination, (2) one-time adult vaccination at 20-64 years, and (3) adult vaccination with decennial boosters. Our main outcome measures were costs (2006 Euros), cases prevented, incremental cost per case prevented and incremental cost per quality-adjusted life year (QALY) saved. We performed sensitivity analyses for key assumptions in the model including disease incidence, vaccine cost, vaccine efficacy, disease costs and frequency of adverse events. Future costs and benefits were discounted at 3%.

RESULTS

At a disease incidence of 165 per 100,000, the one-time adult vaccination strategy would prevent 498,000 cases, and the decennial adult vaccination strategy would prevent 1 million cases. Approximately 31 million adults (approximately 62% of the cohort) would be vaccinated with a one-time adult vaccination strategy for a total program cost of 366 million Euros, while a decennial vaccination strategy would cost 687 million Euros. The one-time adult vaccination strategy resulted in CE ratios of 5800 Euros per QALY saved, or 160 Euros per pertussis case prevented. The decennial booster strategy cost 7200 Euros per QALY saved, or 200 Euros per case prevented. The results were most sensitive to assumptions about disease incidence and vaccine cost.

CONCLUSIONS

Routine vaccination of German adults aged 20-64 years with Tdap is cost-effective.

Authors+Show Affiliations

Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MO 02215, United States.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

18538901

Citation

Lee, Grace M., et al. "Cost-effectiveness of Adult Pertussis Vaccination in Germany." Vaccine, vol. 26, no. 29-30, 2008, pp. 3673-9.
Lee GM, Riffelmann M, Wirsing von Konig CH. Cost-effectiveness of adult pertussis vaccination in Germany. Vaccine. 2008;26(29-30):3673-9.
Lee, G. M., Riffelmann, M., & Wirsing von Konig, C. H. (2008). Cost-effectiveness of adult pertussis vaccination in Germany. Vaccine, 26(29-30), 3673-9. https://doi.org/10.1016/j.vaccine.2008.04.068
Lee GM, Riffelmann M, Wirsing von Konig CH. Cost-effectiveness of Adult Pertussis Vaccination in Germany. Vaccine. 2008 Jul 4;26(29-30):3673-9. PubMed PMID: 18538901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of adult pertussis vaccination in Germany. AU - Lee,Grace M, AU - Riffelmann,Marion, AU - Wirsing von Konig,Carl Heinz, Y1 - 2008/05/19/ PY - 2007/09/14/received PY - 2008/03/13/revised PY - 2008/04/28/accepted PY - 2008/6/10/pubmed PY - 2008/9/13/medline PY - 2008/6/10/entrez SP - 3673 EP - 9 JF - Vaccine JO - Vaccine VL - 26 IS - 29-30 N2 - BACKGROUND: The incidence of pertussis in adults is high despite good childhood vaccination coverage. An adult formulation of an acellular pertussis vaccine is licensed and available for use in Germany. OBJECTIVE: To evaluate the potential health benefits, risks, costs and cost-effectiveness of routine pertussis vaccination programs for German adults. METHODS: A Markov model was used to simulate health states and immunity levels associated with pertussis disease and vaccination. The following strategies were evaluated: (1) no adult pertussis vaccination, (2) one-time adult vaccination at 20-64 years, and (3) adult vaccination with decennial boosters. Our main outcome measures were costs (2006 Euros), cases prevented, incremental cost per case prevented and incremental cost per quality-adjusted life year (QALY) saved. We performed sensitivity analyses for key assumptions in the model including disease incidence, vaccine cost, vaccine efficacy, disease costs and frequency of adverse events. Future costs and benefits were discounted at 3%. RESULTS: At a disease incidence of 165 per 100,000, the one-time adult vaccination strategy would prevent 498,000 cases, and the decennial adult vaccination strategy would prevent 1 million cases. Approximately 31 million adults (approximately 62% of the cohort) would be vaccinated with a one-time adult vaccination strategy for a total program cost of 366 million Euros, while a decennial vaccination strategy would cost 687 million Euros. The one-time adult vaccination strategy resulted in CE ratios of 5800 Euros per QALY saved, or 160 Euros per pertussis case prevented. The decennial booster strategy cost 7200 Euros per QALY saved, or 200 Euros per case prevented. The results were most sensitive to assumptions about disease incidence and vaccine cost. CONCLUSIONS: Routine vaccination of German adults aged 20-64 years with Tdap is cost-effective. SN - 0264-410X UR - https://www.unboundmedicine.com/medline/citation/18538901/Cost_effectiveness_of_adult_pertussis_vaccination_in_Germany_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(08)00536-7 DB - PRIME DP - Unbound Medicine ER -