Anti-meningococcal B vaccination in Italian adolescents: a cost-effective health opportunity

• Published in: European journal of public health 2020-09, Vol.30 (Supplement_5)
• Main Authors: Panatto, D, Landa, P, Amicizia, D, Lai, P L, Lecini, E, Bechini, A, Bonanni, P, Boccalini, S
• Format: Article
• Language: English
• Subjects: Adolescents; Airborne microorganisms; Complications; Cost benefit analysis; Cost control; Developed countries; Disease; Economics; Epidemiology; Health care expenditures; Health services; Immunization; Invasive meningococcal disease; Lethality; Markov chains; Meningococcal disease; Public health; Schedules; Teenagers; Utilities; Vaccination; Vaccines
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckaa166.586

Abstract Background Invasive disease due to Neisseria meningitidis (Nm) is a serious public health problem even in developed countries, owing to its high lethality rate (8-15%) and the invalidating sequelae suffered by many (up to 60%) survivors. As the microorganism is transmitted via the airborne route, the only available weapon in the fight against Nm invasive disease is vaccination. Our aim was to carry out an HTA to evaluate the costs and benefits of anti-meningococcal B (MenB) vaccination with Trumenba® in adolescents in Italy, while also considering the impact of this new vaccination strategy on organizational and ethics aspects. Methods A lifetime Markov model was developed. MenB vaccination with the two-dose schedule of Trumenba® in adolescents was compared with 'non-vaccination'. Two perspectives were considered: the National Health Service (NHS) and society. Three disease phases were defined: acute, post-acute and long-term. Epidemiological, economic and health utilities data were taken from Italian and international literature. The analysis was conducted by means of Microsoft Excel 2010®. Results Our study indicated that vaccinating adolescents (11th year of life) with Trumenba® was cost-effective with an ICER = € 7,912/QALY from the NHS perspective and € 7,758/QALY from the perspective of society. Vaccinating adolescents reduces the number of cases of disease due to meningococcus B in one of the periods of highest incidence of the disease, resulting in significant economic and health savings. Conclusions This is the first study to evaluate the overall impact of free MenB vaccination in adolescents both in Italy and in the international setting. Although cases of invasive disease due to meningococcus B are few, if the overall impact of the disease is adequately considered, it becomes clear that including anti-meningococcal B vaccination into the immunization program for adolescents is strongly recommended from the health and economic standpoints. Key messages Free, large-scale MenB vaccination is key to strengthening the global fight against invasive meningococcal disease. Anti-meningococcal B vaccination in adolescents is a cost-effective health opportunity.