Burgess Colleen, Kujawski Stephanie, Lapornik Ajda, Bencina Goran, Pawaskar Manjiri
Merck & Co., Inc., Rahway, New Jersey.
MSD Inovativna zdravilla d.o.o., Ljubljana, Slovenia.
J Health Econ Outcomes Res. 2022 Sep 20;9(2):95-102. doi: 10.36469/001c.37308. eCollection 2022.
Despite the substantial burden of varicella infection, Slovenia does not currently have a universal varicella vaccination (UVV) program. We modeled the long-term clinical and economic impact of implementing 2-dose UVV strategies compared with no vaccination in Slovenia. A previously published dynamic transmission model was adapted to the demographics, varicella seroprevalence, herpes zoster incidence, and contact patterns in Slovenia. Six 2-dose UVV strategies, vs no vaccination, were considered over a 50-year period, including monovalent vaccination (Varivax [V-MSD] or Varilrix [V-GSK]) at ages 12 and 24 months, or monovalent vaccination at 15 months followed by monovalent or quadrivalent vaccination (ProQuad [MMRV-MSD] or Priorix- Tetra [MMRV-GSK]) at 5.5 years. Costs, quality-adjusted life-years, and incremental cost-effectiveness ratios vs no vaccination were calculated to assess the economic impact of each strategy from payer and societal perspectives. The incidence of varicella infection was estimated as 1228 per 100 000 population in the absence of UVV. Over 50 years, depending on vaccination strategy, UVV reduced varicella cases by 77% to 85% and was associated with substantial reductions in varicella deaths (39%-44%), outpatient cases (74%-82%), and hospitalizations (74%-82%). The greatest reductions were predicted with V-MSD (15 months/5.5 years) and V MSD/MMRV-MSD (15 months/5.5 years). All 2-dose UVV strategies were cost-effective compared with no vaccination from payer and societal perspectives, with V-MSD (15 months/5.5 years) being the most favorable from both perspectives. Policymakers should consider implementing UVV to reduce the burden of varicella disease in Slovenia.
尽管水痘感染负担沉重，但斯洛文尼亚目前没有通用的水痘疫苗接种（UVV）计划。我们模拟了在斯洛文尼亚实施两剂UVV策略与不接种疫苗相比的长期临床和经济影响。一个先前发表的动态传播模型根据斯洛文尼亚的人口统计学、水痘血清阳性率、带状疱疹发病率和接触模式进行了调整。在50年的时间里，考虑了六种两剂UVV策略与不接种疫苗的情况，包括在12个月和24个月时接种单价疫苗（Varivax [V-MSD] 或Varilrix [V-GSK]），或在15个月时接种单价疫苗，随后在5.5岁时接种单价或四价疫苗（ProQuad [MMRV-MSD] 或Priorix-Tetra [MMRV-GSK]）。计算了与不接种疫苗相比的成本、质量调整生命年和增量成本效益比，以从支付方和社会角度评估每种策略的经济影响。在没有UVV的情况下，水痘感染发病率估计为每10万人口1228例。在50年的时间里，根据疫苗接种策略的不同，UVV可将水痘病例减少77%至85%，并大幅减少水痘死亡（39%-44%）、门诊病例（74%-82%）和住院病例（74%-82%）。预计使用V-MSD（15个月/5.5岁）和V MSD/MMRV-MSD（15个月/5.5岁）时减少幅度最大。从支付方和社会角度来看，所有两剂UVV策略与不接种疫苗相比都具有成本效益，其中V-MSD（15个月/5.5岁）从两个角度来看都是最有利的。政策制定者应考虑实施UVV，以减轻斯洛文尼亚水痘疾病的负担。
