Economic evaluation ofHaemophilus influenzaetype b vaccination in Moscow, Russian Federation

• Published in: Vaccine Vol. 24; no. 13; p. 2367
• Main Authors: Platonov, AE, Griffiths, UK, Voeykova, MV, Platonova, OV, Shakhanina, IL, Chistyakova, GG, Robertson, SE
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Limited 20.03.2006
• Subjects: Epidemiology; Fatalities; Immunization; Medical treatment; Meningitis; Sensitivity analysis; Vaccines; United States > US
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2005.11.054

Objective To estimate the cost-effectiveness of providingHaemophilus influenzaetype b (Hib) vaccine to children in Moscow in routine immunization services. Methods The incidence of Hib meningitis among children aged <5 years in Moscow was obtained from a prospective surveillance study undertaken during October 1999-September 2001, with treatment cost data collected for all cases. Sequelae in surviving children were assessed in December 2002. The costs of Hib vaccination in Moscow were estimated assuming a vaccine price of US$5 per dose and the same four-dose schedule and 97% coverage as for diphtheria-tetanus-pertussis vaccine. The most uncertain variables were varied in a sensitivity analysis. Results The annual incidence of Hib meningitis was 5.7 per 100,000 children <5 years. The average treatment cost for an acute Hib meningitis case was US$1296. For a patient with sequelae, the average additional lifetime discounted treatment cost was US$15,820. The total annual cost of Hib vaccination of infants in Moscow was estimated as US$1.5 million per year. In the base case analysis, the cost-effectiveness ratios amount to US$77,503 per Hib meningitis case averted and US$10,842 per discounted disability adjusted life year averted. The break-even vaccine price, where the annual vaccination costs equal annual treatment costs averted, is only US$0.04 per dose in the base case scenario. If discounted indirect costs are included, the break-even vaccine price is US$0.5 per dose. Conclusion In Moscow, the incidence of Hib meningitis is low and the costs of hospitalization and subsequent medical treatment are relatively inexpensive. Given these factors, Hib vaccine at US$5 per dose would not be a cost-effective option in Moscow at the present time.