Cost-Effectiveness of Routine Infant Meningococcal B Vaccination in the Netherlands.

INTRODUCTION

Invasive meningococcal disease (IMD) is a severe infectious disease that can cause mortality and debilitating sequelae. IMD is typically vaccine-preventable. In the Netherlands, meningococcal serogroup B (MenB) causes almost all IMD cases. The objective of this study was to assess the cost-effectiveness of routine infant MenB vaccination in the Netherlands, using the latest incidence data, real-world evidence and vaccine data.

METHODS

We used the dynamic transmission cost-effectiveness (DyCE) model to compare routine infant vaccination with three doses of the four-component meningococcal B vaccine (4CMenB) versus no MenB vaccination, from a societal perspective. The model followed 100 cohorts over lifetime, was updated with the most recent Dutch epidemiological evidence, and was adapted in accordance with the latest Dutch health economic guidelines. Additionally, IMD incidence was varied in scenario analyses to model the unpredictable incidence of MenB IMD and potential outbreaks of this disease.

RESULTS

Over lifetime, 2367 MenB IMD cases, 1077 long-term sequelae cases and 116 deaths were prevented with 4CMenB vaccination in the base case. 4CMenB vaccination saved 14,703 quality-adjusted life years (QALYs), predominantly by preventing long-term sequelae (45.5%) and deaths (52.2%). The incremental cost-effectiveness ratio (ICER) was €99,752 per QALY gained in the base case and decreased below the willingness-to-pay threshold of 80,000 if the IMD incidence increased by 24%, or if the vaccine acquisition costs decreased by 22% (from €78.5 to €61.45). The ICER was most sensitive to variations in vaccine effectiveness, the incidence of MenB IMD and vaccine acquisition costs.

CONCLUSIONS

In the Netherlands, 4CMenB vaccination is likely to be cost-effective if MenB incidence increases by 24%. This comprehensive analysis provides decision-makers with new and updated information on the cost-effectiveness of infant vaccination with 4CMenB in the Netherlands.