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Cost-Effectiveness of Adolescent Pertussis Vaccination for The Netherlands: Using an Individual-Based Dynamic Model

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  • Robin de Vries
  • Mirjam Kretzschmar
  • Joop F P Schellekens
  • Florens G A Versteegh
  • Tjalke A Westra
  • John J Roord
  • Maarten J Postma

Abstract

Background: Despite widespread immunization programs, a clear increase in pertussis incidence is apparent in many developed countries during the last decades. Consequently, additional immunization strategies are considered to reduce the burden of disease. The aim of this study is to design an individual-based stochastic dynamic framework to model pertussis transmission in the population in order to predict the epidemiologic and economic consequences of the implementation of universal booster vaccination programs. Using this framework, we estimate the cost-effectiveness of universal adolescent pertussis booster vaccination at the age of 12 years in the Netherlands. Methods/Principal Findings: We designed a discrete event simulation (DES) model to predict the epidemiological and economic consequences of implementing universal adolescent booster vaccination. We used national age-specific notification data over the period 1996–2000—corrected for underreporting—to calibrate the model assuming a steady state situation. Subsequently, booster vaccination was introduced. Input parameters of the model were derived from literature, national data sources (e.g. costing data, incidence and hospitalization data) and expert opinions. As there is no consensus on the duration of immunity acquired by natural infection, we considered two scenarios for this duration of protection (i.e. 8 and 15 years). In both scenarios, total pertussis incidence decreased as a result of adolescent vaccination. From a societal perspective, the cost-effectiveness was estimated at €4418/QALY (range: 3205–6364 € per QALY) and €6371/QALY (range: 4139–9549 € per QALY) for the 8- and 15-year protection scenarios, respectively. Sensitivity analyses revealed that the outcomes are most sensitive to the quality of life weights used for pertussis disease. Conclusions/Significance: To our knowledge we designed the first individual-based dynamic framework to model pertussis transmission in the population. This study indicates that adolescent pertussis vaccination is likely to be a cost-effective intervention for The Netherlands. The model is suited to investigate further pertussis booster vaccination strategies.

Suggested Citation

  • Robin de Vries & Mirjam Kretzschmar & Joop F P Schellekens & Florens G A Versteegh & Tjalke A Westra & John J Roord & Maarten J Postma, 2010. "Cost-Effectiveness of Adolescent Pertussis Vaccination for The Netherlands: Using an Individual-Based Dynamic Model," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-11, October.
    • Handle: RePEc:plo:pone00:0013392
    DOI: 10.1371/journal.pone.0013392
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    References listed on IDEAS

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    1. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    2. Koopmanschap, Marc A. & Rutten, Frans F. H. & van Ineveld, B. Martin & van Roijen, Leona, 1995. "The friction cost method for measuring indirect costs of disease," Journal of Health Economics, Elsevier, vol. 14(2), pages 171-189, June.
    3. Jonathan Karnon, 2003. "Alternative decision modelling techniques for the evaluation of health care technologies: Markov processes versus discrete event simulation," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 837-848, October.
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    1. Elisabetta De Cao & Alessia Melegaro & Rogier Klok & Maarten Postma, 2014. "Optimising Assessments of the Epidemiological Impact in the Netherlands of Paediatric Immunisation with 13-Valent Pneumococcal Conjugate Vaccine Using Dynamic Transmission Modelling," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    2. Rivero-Santana, Amado & Cuéllar-Pompa, Leticia & Sánchez-Gómez, Luis M. & Perestelo-Pérez, Lilisbeth & Serrano-Aguilar, Pedro, 2014. "Effectiveness and cost-effectiveness of different immunization strategies against whooping cough to reduce child morbidity and mortality," Health Policy, Elsevier, vol. 115(1), pages 82-91.

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