Année
2024
Auteurs
PUYOU DE POUVOURVILLE Gérard, Breau-Brunel Manon, Loncle-Provot Véronique, Beck Ekkehard, Gaugain Loïg, Nachbaur Gaëlle, Pribil Céline
Abstract
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/qualityadjusted 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.
PUYOU DE POUVOURVILLE, G., BREAU-BRUNEL, M., LONCLE-PROVOT, V., BECK, E., GAUGAIN, L., NACHBAUR, G. et PRIBIL, C. (2024). Public Health Impact and Cost-Effectiveness Analysis of 4-Component Meningococcal Serotype B Vaccination for Infants in France. PharmacoEconomics – Open, In press.