What We Know Now: An Economic Evaluation of Chickenpox Vaccination and Dose Timing Using an Agent-Based Model.

Abstract

OBJECTIVES:

The value of chickenpox vaccination is still debated in the literature and by jurisdictions worldwide. This uncertainty is reflected in the inconsistent uptake of the vaccine, where some countries offer routine childhood immunization programs, others have targeted programs, and in many the vaccine is only privately available. Even across the countries that have universal funding for the vaccine, there is a diversity of schedules and dosing intervals. Using an agent-based model of chickenpox and shingles, we conducted an economic evaluation of chickenpox vaccination in Alberta, Canada.

METHODS:

We compared the cost-effectiveness of 2 common chickenpox vaccination schedules, specifically a long dosing interval (first dose: 12 months; second dose: 4-6 years) and a short dosing interval (first dose: 12 months; second dose: 18 months).

RESULTS:

The economic evaluation demonstrated a shorter dosing interval may be marginally preferred, although it consistently led to higher costs from both the societal and healthcare perspectives. We found that chickenpox vaccination would be cost-saving and highly cost-effective from the societal and healthcare perspective, assuming there was no impact on shingles.

CONCLUSION:

Chickenpox vaccine was cost-effective when not considering shingles and remained so even if there was a minor increase in shingles following vaccination. However, if chickenpox vaccination did lead to a substantial increase in shingles, then chickenpox vaccination was not cost-effective from the healthcare perspective.

• Authors: Ellen R S Rafferty, Wade McDonald, Nathaniel D Osgood, Alexander Doroshenko, Marwa Farag
• Journal: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research (Value Health) Vol. 24 Issue 1 Pg. 50-60 (01 2021) ISSN: 1524-4733 [Electronic] United States
• PMID: 33431153 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.

Chemical References

• Chickenpox Vaccine

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Alberta (epidemiology)
• Chickenpox (economics, epidemiology, prevention & control)
• Chickenpox Vaccine (administration & dosage, economics)
• Child
• Child, Preschool
• Cost-Benefit Analysis
• Health Expenditures
• Health Services (economics, statistics & numerical data)
• Herpes Zoster (epidemiology)
• Humans
• Immunization Programs (economics)
• Immunization Schedule
• Infant
• Middle Aged
• Models, Economic
• Young Adult