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A cost-effectiveness analysis of vaccination strategies against N. meningitidis meningitis in sub-Saharan African countries

Author

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  • Bovier, Patrick A.
  • Wyss, Kaspar
  • J. Au, Heather

Abstract

This analysis evaluates the cost-effectiveness (C/E) of routine vaccination against Neisseria meningitidis. Three different preventive strategies are analyzed: mass vaccination during epidemics (the current standard of care), routine preventive vaccination and a combination strategy of routine vaccination with mass vaccination during epidemics. A Markov model is used to simulate the epidemics of meningitis in a cohort of 5-year old children and compare these different strategies. The results show that mass vaccination strategy is dominated by the two other strategies. The incremental C/E ratios are US$50/QALY for the routine vaccination, and US$199/QALY for the combination strategy. The costs per fatal case averted are US$1161 for the routine vaccination, and US$2397 for the combination strategy. The C/E ratios are sensitive to: the incidence of meningococcal meningitis, the costs of treating cases, the costs of routine vaccination and the costs and effectiveness of mass immunization campaign. However the rank ordering of the strategies is almost never altered. In conclusion, the results of this analysis suggest that mass vaccination in sub-Saharan Africa in case of epidemics should be reconsidered. Routine vaccination against meningococcal meningitis at an early age, with or without mass vaccination during epidemics is more effective, with a C/E ratio within the range of other vaccination strategies currently in place in Africa.

Suggested Citation

  • Bovier, Patrick A. & Wyss, Kaspar & J. Au, Heather, 1999. "A cost-effectiveness analysis of vaccination strategies against N. meningitidis meningitis in sub-Saharan African countries," Social Science & Medicine, Elsevier, vol. 48(9), pages 1205-1220, May.
    • Handle: RePEc:eee:socmed:v:48:y:1999:i:9:p:1205-1220
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    Cited by:

    1. Andreas Kuznik & Garba Iliyasu & Mohammed Lamorde & Mustapha Mahmud & Baba M Musa & Ibrahim Nashabaru & Stephen Obaro & Idris Mohammed & Abdulrazaq G Habib, 2017. "Cost-effectiveness of expanding childhood routine immunization against Neisseria meningitidis serogroups C, W and Y with a quadrivalent conjugate vaccine in the African meningitis belt," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-12, November.
    2. Paul Gavaza & Karen Rascati & Abiola Oladapo & Star Khoza, 2012. "The State of Health Economic Research in South Africa," PharmacoEconomics, Springer, vol. 30(10), pages 925-940, October.
    3. Zana C Somda & Helen N Perry & Nancy R Messonnier & Mamadou H Djingarey & Salimata Ouedraogo Ki & Martin I Meltzer, 2010. "Modeling the Cost-Effectiveness of the Integrated Disease Surveillance and Response (IDSR) System: Meningitis in Burkina Faso," PLOS ONE, Public Library of Science, vol. 5(9), pages 1-10, September.

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