PharmacoEconomics & Outcomes News 361 - 4 May 2002 DTaP vaccine booster worth it in the UK The introduction of a diphtheria, tetanus and acellular pertussis (DTaP) vaccine booster for pre-school children in the UK would significantly reduce the number of pertussis infections and provide significant cost offsets, according to UK-based researchers. They developed a Markov model to estimate the costs and benefits associated with introducing a DTaP vaccine booster to the existing primary vaccination schedule for 682 700 children aged 4–5 years in England and Wales, assuming a booster coverage rate of 84–85%. * The model was run over a 5-year time span incorporating two scenarios; in scenario one, a low underlying rate of pertussis was combined with a long-lasting period of vaccine protection, and in scenario two, a much larger pertussis burden was combined with a shorter period of vaccine protection. The model revealed that additional costs associated with the booster vaccine would be £15.36 million over 5 years, compared with no booster vaccine. ** Under scenario one, the estimated cost per quality-adjusted life-year (QALY) gained would be £35 000 assuming QALY losses of 0.2 per hospitalisation and 0.02 per pertussis infection; under scenario two, the cost per QALY gained would be around £14 500, relative to no booster vaccine. The respective values would become £70 000 and £29 000 if assumptions were changed to QALY losses of 0.1 per hospitalisation and 0.01 per infection. The researchers say that this large range of QALY estimates indicates that ‘future work is needed on determining the true value of pertussis on quality of life’. Assuming a 60% rate of vaccine uptake, ‘the herd immunity effect was strong enough to prevent a large number of pertussis infections’, note the researchers. Under this scenario, total costs associated with the booster vaccine would be around £10.97 million, while £3.16 million in primary- and secondary-care costs would be avoided, relative to no booster vaccine. Thus, the booster vaccine was associated with additional expenditure of £7.82 million and the avoidance of more than 1100 hospitalisations and 22 000 pertussis infections at a cost of £348 per infection avoided, relative to no booster vaccine. * The study was sponsored by GlaxoSmithKline. ** Costs (2000 values) were those associated with the booster vaccine, hospitalisation, general practitioner consultations and specialist care, and were discounted at 6% per annum. Stevenson M, et al. Estimating the potential health gain and cost consequences of introducing a pre-school DTPa pertussis booster into the UK child vaccination schedule. Vaccine 20: 1778-1786, 15 Mar 2002 800905387 1 PharmacoEconomics & Outcomes News 4 May 2002 No. 361 1173-5503/10/0361-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

DTaP vaccine booster worth it in the UK

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PharmacoEconomics & Outcomes News 361 - 4 May 2002

DTaP vaccine booster worth it inthe UK

The introduction of a diphtheria, tetanus and acellularpertussis (DTaP) vaccine booster for pre-school childrenin the UK would significantly reduce the number ofpertussis infections and provide significant cost offsets,according to UK-based researchers.

They developed a Markov model to estimate the costsand benefits associated with introducing a DTaP vaccinebooster to the existing primary vaccination schedule for682 700 children aged 4–5 years in England and Wales,assuming a booster coverage rate of 84–85%.* Themodel was run over a 5-year time span incorporatingtwo scenarios; in scenario one, a low underlying rate ofpertussis was combined with a long-lasting period ofvaccine protection, and in scenario two, a much largerpertussis burden was combined with a shorter period ofvaccine protection.

The model revealed that additional costs associatedwith the booster vaccine would be £15.36 million over 5years, compared with no booster vaccine.** Underscenario one, the estimated cost per quality-adjustedlife-year (QALY) gained would be £35 000 assumingQALY losses of 0.2 per hospitalisation and 0.02 perpertussis infection; under scenario two, the cost perQALY gained would be around £14 500, relative to nobooster vaccine. The respective values would become£70 000 and £29 000 if assumptions were changed toQALY losses of 0.1 per hospitalisation and 0.01 perinfection. The researchers say that this large range ofQALY estimates indicates that ‘future work is needed ondetermining the true value of pertussis on quality of life’.

Assuming a 60% rate of vaccine uptake, ‘the herdimmunity effect was strong enough to prevent a largenumber of pertussis infections’, note the researchers.Under this scenario, total costs associated with thebooster vaccine would be around £10.97 million, while£3.16 million in primary- and secondary-care costswould be avoided, relative to no booster vaccine. Thus,the booster vaccine was associated with additionalexpenditure of £7.82 million and the avoidance of morethan 1100 hospitalisations and 22 000 pertussisinfections at a cost of £348 per infection avoided,relative to no booster vaccine.* The study was sponsored by GlaxoSmithKline.** Costs (2000 values) were those associated with the boostervaccine, hospitalisation, general practitioner consultations andspecialist care, and were discounted at 6% per annum.

Stevenson M, et al. Estimating the potential health gain and cost consequences ofintroducing a pre-school DTPa pertussis booster into the UK child vaccinationschedule. Vaccine 20: 1778-1786, 15 Mar 2002 800905387