Table 7

Cost-effectiveness and cost-utility analyses of vaccination programs in the general population
First author [Reference] Chapalain [[35]] Kandola [[36]] Hudeckova [[37]] Zhou [[38]] Lugner [[39]]
Country France Guyana Slovakia USA Netherlands
Year 1978 1998 2001 2004 2010
WB income group High Upper-middle High High High
Comparators 1. Vaccinate 13-yr-olds and women 1. Rubella eradication campaign 1. National vaccination campaign 1. Rubella vaccination program 1. Screen and vaccinate all unvaccinated in LVR
2. No vaccination 2. No campaign 2. No campaign 2. No vaccination program 2. Screen and vaccinate all pregnant in LVR
3. Screen and vaccinate all unvaccinated in NL
Perspective Payer* NR Payer Societal Payer
Cost components measured Vaccination; specialist training; research; antenatal supervision; improvement of obstetric care; intensive care NR NR** Vaccination; OP care; hospitalization; institutional care; special care; Indirect (premature mortality, disability, missed work) Vaccination; screening; healthcare costs
Method of cost estimation Top-down costing NR NR** Micro-costing; Human capital approach (indirect costs) Micro-costing
Time period for costs and benefits 15 years 5 years NR** 40 years 16 years
Discounting (Rate) Yes (NR) NR NR** Yes (3%) Yes (4%)
Outcomes Mortality; lives saved CRS cases prevented Rubella cases prevented Cases prevented; lives saved QALYs
Method of outcome measurement Primary analysis of program data NR NR** Decision model Model-based
Results—ICER (2012 US$/Outcome) $20,474/Life saved $3,335/CRS case prevented $313/Case prevented Vaccination program was dominant 1 dominated 2; the ICER comparing 3 to 1 was $114,575/QALY gained
Stated conclusion The immunization program was cost-effective Rubella eradication is highly cost-effective National MMR immunization program was cost-effective Two-dose MMR vaccination program is cost-effective Screening and vaccinating all unvaccinated women is the most cost-effective
QHES score 30 NS NS 93 62
Sponsor NR NR NR CDC NL CIDC

*Not explicitly reported but inferred **Article in Slovak.

WB, World Bank; NR, Not Reported; NS, Not Scored; OP, Out Patient; LVR, Low vaccination coverage regions; NL, Netherlands; CDC, US Centers for Disease Control and Prevention; CIDC, Center for Infectious Disease Control; QALYs, Quality-Adjusted Life-Years.

Babigumira et al.

Babigumira et al. BMC Public Health 2013 13:406   doi:10.1186/1471-2458-13-406

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