Modelling cost effectiveness of meningococcal serogroup C conjugate vaccination campaign in England and Wales

Objectives To assess die cost effectiveness of a meningococcal serogroup C conjugate vaccination campaign in 0-17 year olds. Design Cost effectiveness analysis from the perspective of die healthcare provider. Setting England and Wales. Main outcome measure Cost per life year saved. Results In 1998-9, immediately before the introduction of meningococcal C vaccination, die burden of serogroup C disease was considerable, with an estimated 1137 cases in people aged 0-17 years and at least 72 deaths. The vaccination campaign is estimated to have cost between pound126m ($180m, E207m) and pound241 m ($343m, E395m), depending on the price of the vaccine. Under base case assumptions die cost per life year saved from the vaccination campaign is estimated to be pound6259 ($8919, E10 264). School based vaccination was more cost effective than general practice based vaccination because of lower delivery Costs. Immunisation of infants aged under I year was the least cost effective component of the campaign because, although this maximises the life years gained, the three dose schedule required is more expensive than other methods of delivery. Estimates of the cost per life year saved were sensitive to assumptions on the future incidence of disease and the case fatality ratio. Conclusions Meningococcal C vaccination is likely to be more cost effective in all age groups when the incidence of disease is high. It is also more cost effective when given to children aged 1-4 (by general practitioners) and to children and young people aged 5-17 years at school than when administered to infants under 12 months of age or youths aged 16-17 years who are not at school.