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1389. Economic Evaluation of Universal Varicella Vaccination in Mexico

BACKGROUND: Universal varicella vaccination (UVV) has proven to be cost-effective in countries where implemented. However, this has not yet been evaluated for Mexico. We assessed the cost-effectiveness of UVV in the Mexican Immunization Program from both healthcare and societal perspectives. METHODS...

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Autores principales: Chacon-Cruz, Enrique, Meroc, Estelle, Costa-Clemens, Sue Ann, Verstraeten, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776260/
http://dx.doi.org/10.1093/ofid/ofaa439.1571
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author Chacon-Cruz, Enrique
Meroc, Estelle
Costa-Clemens, Sue Ann
Verstraeten, Thomas
author_facet Chacon-Cruz, Enrique
Meroc, Estelle
Costa-Clemens, Sue Ann
Verstraeten, Thomas
author_sort Chacon-Cruz, Enrique
collection PubMed
description BACKGROUND: Universal varicella vaccination (UVV) has proven to be cost-effective in countries where implemented. However, this has not yet been evaluated for Mexico. We assessed the cost-effectiveness of UVV in the Mexican Immunization Program from both healthcare and societal perspectives. METHODS: The annual disease burden (varicella cases/deaths, outpatient visits, and hospitalizations) were derived from Mexican seroprevalence-published data adjusted to the 2020 country’s population. The annual economic burden was calculated by combining disease with Mexican published unit cost data. Four different vaccination strategies were evaluated: 1. One dose of a single varicella vaccine at 1 year old; 2. Two doses of single varicella vaccine at 1 and 6 years; 3. One dose of a single varicella vaccine at 1 year, and quadrivalent measles-mumps-rubella-varicella vaccine (MMRV) at 6 years; 4. Two doses of MMRV at 1 and 6 years. We developed an economic model for each vaccination strategy where 20 consecutive birth cohorts were simulated. The impact of vaccination (number of avoided cases/deaths) was evaluated for a 20 years follow-up period based on vaccine effectiveness (87% and 97.4%), and assuming a 95% coverage. Subsequently, we estimated net vaccination costs, benefit-cost ratio (BCR), annual costs saved, cost-effectiveness ratio. RESULTS: From annual disease burden estimation, avoided cases with one dose, and two doses were of 20,570,722 and 23,029,751, respectively. From the 20 years cohort, the yearly number of varicella cases was estimated at 2,041,296, and total costs at $115,565,315 (USD) (healthcare perspective) and $165,372,061 (healthcare and societal perspectives). Strategies 1 and 2 were found to be cost-saving (BCR >1) (Figure 1), and strategy 3 to be cost-effective (CE) ($1539 per Life Year Gained). Strategy 4 was not CE. Strategies 1 and 2 would allow saving annually $53.16 million and $34.41 million, respectively, to the Mexican society. FIGURE 1 [Image: see text] CONCLUSION: 1.The disease and economic burden of varicella in Mexico are high. 2.UVV with four different vaccination strategies results in a high reduction of cases. 3.From healthcare and societal perspectives, UVV was shown to be cost-effective (with strategy 3), and cost-saving (with strategies using one dose or two doses separately). DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77762602021-01-07 1389. Economic Evaluation of Universal Varicella Vaccination in Mexico Chacon-Cruz, Enrique Meroc, Estelle Costa-Clemens, Sue Ann Verstraeten, Thomas Open Forum Infect Dis Poster Abstracts BACKGROUND: Universal varicella vaccination (UVV) has proven to be cost-effective in countries where implemented. However, this has not yet been evaluated for Mexico. We assessed the cost-effectiveness of UVV in the Mexican Immunization Program from both healthcare and societal perspectives. METHODS: The annual disease burden (varicella cases/deaths, outpatient visits, and hospitalizations) were derived from Mexican seroprevalence-published data adjusted to the 2020 country’s population. The annual economic burden was calculated by combining disease with Mexican published unit cost data. Four different vaccination strategies were evaluated: 1. One dose of a single varicella vaccine at 1 year old; 2. Two doses of single varicella vaccine at 1 and 6 years; 3. One dose of a single varicella vaccine at 1 year, and quadrivalent measles-mumps-rubella-varicella vaccine (MMRV) at 6 years; 4. Two doses of MMRV at 1 and 6 years. We developed an economic model for each vaccination strategy where 20 consecutive birth cohorts were simulated. The impact of vaccination (number of avoided cases/deaths) was evaluated for a 20 years follow-up period based on vaccine effectiveness (87% and 97.4%), and assuming a 95% coverage. Subsequently, we estimated net vaccination costs, benefit-cost ratio (BCR), annual costs saved, cost-effectiveness ratio. RESULTS: From annual disease burden estimation, avoided cases with one dose, and two doses were of 20,570,722 and 23,029,751, respectively. From the 20 years cohort, the yearly number of varicella cases was estimated at 2,041,296, and total costs at $115,565,315 (USD) (healthcare perspective) and $165,372,061 (healthcare and societal perspectives). Strategies 1 and 2 were found to be cost-saving (BCR >1) (Figure 1), and strategy 3 to be cost-effective (CE) ($1539 per Life Year Gained). Strategy 4 was not CE. Strategies 1 and 2 would allow saving annually $53.16 million and $34.41 million, respectively, to the Mexican society. FIGURE 1 [Image: see text] CONCLUSION: 1.The disease and economic burden of varicella in Mexico are high. 2.UVV with four different vaccination strategies results in a high reduction of cases. 3.From healthcare and societal perspectives, UVV was shown to be cost-effective (with strategy 3), and cost-saving (with strategies using one dose or two doses separately). DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7776260/ http://dx.doi.org/10.1093/ofid/ofaa439.1571 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Chacon-Cruz, Enrique
Meroc, Estelle
Costa-Clemens, Sue Ann
Verstraeten, Thomas
1389. Economic Evaluation of Universal Varicella Vaccination in Mexico
title 1389. Economic Evaluation of Universal Varicella Vaccination in Mexico
title_full 1389. Economic Evaluation of Universal Varicella Vaccination in Mexico
title_fullStr 1389. Economic Evaluation of Universal Varicella Vaccination in Mexico
title_full_unstemmed 1389. Economic Evaluation of Universal Varicella Vaccination in Mexico
title_short 1389. Economic Evaluation of Universal Varicella Vaccination in Mexico
title_sort 1389. economic evaluation of universal varicella vaccination in mexico
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776260/
http://dx.doi.org/10.1093/ofid/ofaa439.1571
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