Cost-effectiveness analysis of universal infant immunization program with meningococcal conjugate vaccine in Brazil

Abstract: 
Objective: To analyze the cost-effectiveness of a meningococcal C vaccination program in Brazil.

Methods: A hypothetical cohort of 3,194,038 children born in Brazil in 2006 was followed for 10 years. A decision tree model was developed on TreeAge Pro 2007 software program to compare universal infant vaccination with current program. Epidemiologic and cost estimates were based on data retrieved from National Health Information Systems and literature. The analysis was conducted from the public health care system and societal perspectives. Costs are expressed in 2006 Brazilian reals (R$).

Results: At 94% coverage, the program would avoid 1,218 cases, 210 deaths, and 14,473 life years lost, a reduction of respectively 45%, 44% and 44%, for the 10-year period. Vaccination costs of R$ 320,9 million would not be offset by R$ 4-7,9 million reductions in disease treatment costs. Nationally vaccination would cost R$21,620 per life year saved from the perspective of the healthcare system and R$ 21,896 per life year saved from the society's perspective. Results were most sensitive to case fatality rate, disease incidence and vaccine cost .

Conclusions: Universal childhood vaccination program against meningococcal C proved to be a cost-effective strategy, supporting the recent decision of the Brazilian government. These results could contribute to defining the most favorable price of the vaccine and for monitoring its impact on population.