Volume 8 • Number 3 • 2005 VALUE IN HEALTH © ISPOR 1098-3015/05/209 209–222 209 Blackwell Science, LtdOxford, UKVHEValue in Health1098-30152005 ISPOR83209222Original ArticleVaricella Vaccination in France and GermanyCoudeville et al. Address correspondence to: Benoît Dervaux, CRESGE, 1 rue Norbert Segard, BP109 59016 Lille Cedex, France. E-mail: [email protected] The Economic Value of Childhood Varicella Vaccination in France and Germany Laurent Coudeville, MD, PhD, 1 Alain Brunot, MD, PhD, 1 Thomas D. Szucs, MD, MBA, MPH, 2 Benoit Dervaux, PhD 1 1 CRESGE-LABORES, Catholic University of Lille, France; 2 Institute of Social and Preventive Medicine, University of Zurich, Switzerland ABSTRACT Objective: To determine the economic impact of child- hood varicella vaccination in France and Germany. Methods: A common methodology based on the use of a varicella transmission model was used for the two coun- tries. Cost data (2002€) were derived from two previous studies. The analysis focused on a routine vaccination program for which three different coverage rates (CRs) were considered (90%, 70%, and 45%). Catch-up strat- egies were also analyzed. A societal perspective including both direct and indirect costs and a third-party payer per- spective were considered (Social Security in France and Sickness Funds in Germany). Results: A routine vaccination program has a clear posi- tive impact on varicella-related morbidity in both coun- tries. With a 90% CR, the number of varicella-related deaths was reduced by 87% in Germany and by 84% in France. In addition, with a CR of 90%, routine varicella vaccination induces savings in both countries from both societal (Germany 61%, France 60%) and third-party payer perspectives (Germany 51%, France 6.7%). For lower CRs, routine vaccination remains cost saving from a third-party payer perspective in Germany but not in France, where it is nevertheless cost-effective (cost per life- year gained of 6521€ in the base case with a 45% CR). Conclusion: Considering the impact of vaccination on varicella morbidity and costs, a routine varicella vaccina- tion program appears to be cost saving in Germany and France from both a societal and a third-party payer perspective. For France, routine varicella vaccination remains cost-effective in worst cases when a third-party payer perspective is adopted. Catch-up programs provide additional savings. Keywords: children vaccination, economic evaluation, model, varicella. Introduction The varicella vaccine, initially developed in Japan [1], is a live attenuated virus vaccine specific for varicella zoster virus (VZV), the virus responsible for varicella and zoster. Following Japan, where the use of the OKA/Biken strain of the varicella virus started in 1974, the United States licensed in 1995 the OKA/Merck strain of the varicella vaccine. Since that time, a growing proportion of young Americans (76.3% of children aged 19–35 months in 2001 [2]) have been vaccinated against varicella. In many European countries, the debate over tar- geted vaccination versus mass vaccination remains open. In this context, the question of the value of varicella vaccination has been addressed in several economic evaluations focused on European [3–7] and other developed countries [8–13] over the last decade. These evaluations can be divided in two cat- egories: those putting forward the benefits associ- ated with a routine vaccination [3,4,6,9–14] and those pointing out the potential risks associated to mass childhood vaccination [5–8]. The advantages of a routine vaccination program derives from the possibility of obtaining through vaccination a dramatic reduction of the burden associated with varicella in terms of morbidity (complications and deaths) and socioeconomic consequences (treatment costs, productivity losses, absenteeism from school). Considering that vari- cella affects all individuals in absence of vaccina- tion, this burden should not be underestimated. The potential risks of varicella vaccination include the increase in the proportion of adult cases that are at high risk of severe disease and the impact on zoster incidence [15]. Analyzing the value of varicella vaccination requires a thorough examination of both epidemi- ological and socioeconomic impact of the vaccina- tion strategies under consideration. Although not
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Related Documents
![CASE OF THE WEEK - WordPress.comfollowing varicella infection. [139] Post-immunization BRPIND occur most frequently following measles, rubella, or mumps vaccination. Many vaccines](https://static.cupdf.com/doc/110x72/5e962969a3631263cb35acd4/case-of-the-week-following-varicella-infection-139-post-immunization-brpind.jpg)