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An economic evaluation of varicella vaccination in Italian adolescents / Nancy Thiry in Vaccine, 22(2004)27-28 ([09/09/2004])
Languages : English (eng)
in Vaccine > 22(2004)27-28 [09/09/2004] . - 3546-3562
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
Adolescent ; Adult ; Age Factors ; Aged ; Chickenpox Vaccine ; Child ; Child, Preschool ; Cost of Illness ; Cost-Benefit Analysis ; Economics ; Encephalitis, Varicella Zoster ; Epidemiology ; Female ; Hospitalization ; Humans ; Italy ; Journal Article ; Male ; Markov Chains ; Mass Immunization ; Middle Aged ; Netherlands ; Peer Review ; prevention and control ; statistics and numerical data [Subheading]Abstract: An economic evaluation was performed to assess five varicella vaccination scenarios targeted to 11-year-old Italian adolescents. The scenarios were: "compulsory vaccination" of all adolescents, recommended vaccination of susceptible adolescents on the basis of an "anamnestic screening", a "blood test" or a combination of both ("both tests") and vaccination of adolescents in the private sector, at the parents' charge ("private vaccination"). Probabilities and unit costs were taken from published sources and experts opinion. The accuracy of the anamnestic screening (81.6% sensitivity and 87.3% specificity) was derived from a separate descriptive study among 344 Italian adolescents. The costs and benefits of each scenario were simulated using a Markov model and cost-effectiveness, budget-impact and cost-benefit analyses were conducted. Of all considered scenarios, "both tests" and "anamnestic screening" were the most appealing options with an estimated net direct cost of 5058 and 8929 per life-year gained (compared to no vaccination) versus 14,693-42,842 for the other scenarios. These two scenarios further resulted in substantial net savings for society (over 600,000 per cohort, BCR: 2.17). The need for a serological confirmation was highly dependent on the sensitivity of the anamnestic screening, which is believed to increase once such a program is launched. For practical considerations, "anamnestic screening" seems to be the most convenient option. Link for e-copy: http://tiny.cc/xktyn Format of e-copy: VDIC IP recognition Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1773 [article]
Languages : English (eng)
in Pharmacoeconomics > 21(2003)1 [01/01/2003] . - 13-18
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
Chickenpox ; Chickenpox Vaccine ; Child ; Child, Preschool ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Economics ; Economics, Pharmaceutical ; Great Britain ; Humans ; Immunization Programs ; Journal Article ; Peer Review ; prevention and control ; statistics and numerical data [Subheading]Abstract: Chickenpox infections are generally mild but due to their very high incidence among healthy children they give rise to considerable morbidity and occasional mortality. With the development of a varicella vaccine in the early 1970s and its progressive licensing in many countries, interest in the efficiency of varicella immunisation programmes grew. The objective of this review was to discuss the methodological aspects and results of published economic evaluations of varicella vaccination. From this, we attempted to make recommendations. A computerised search was carried out; 17 full economic evaluations of varicella vaccination were retrieved. The review identified the methodological divergences and similarities between the articles in four areas: study design, epidemiological data, economic data and model characteristics. We assessed to what extent the applied methods conform to general guidelines for the economic evaluation of healthcare interventions and compared the studies' results. The desirability of a universal vaccination programme depends on whose perspective is taken. Despite variability in data and model assumptions, the studies suggest that universal vaccination of infants is attractive to society because large savings occur from averted unproductive days for parents. For the healthcare payer, universal vaccination of infants does not generate savings. Vaccination of susceptible adolescents has been proposed by some authors as a viable alternative; the attractiveness of this is highly dependent on the negative predictive value of anamnestic screening. Targeted vaccination of healthcare workers and immunocompromised individuals appears relatively cost effective. Findings for other target groups are either contradictory or provide insufficient evidence for any unequivocal recommendations to be made. High sensitivity to vaccine price was reported in most studies. This review highlights that some aspects of these studies need to be further improved before final recommendations can be made. First, more transparency, completeness and compliance to general methodological guidelines are required. Second, because of the increasing severity of varicella with age, it is preferable and in some cases essential to use dynamic models for the assessment of universal vaccination strategies. Third, most studies focused on the strategy of vaccinating children only while their results depended heavily on disputable assumptions (regarding vaccine effectiveness and impact on herpes zoster). Since violation of these assumptions could have important adverse public health effects, we suggest pre-adolescent vaccination as a more secure alternative. This option deserves more attention in future analyses Link for e-copy: http://adisonline.com/pharmacoeconomics/toc/2003/21010#1491356273 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2435 [article]Kosteneffectiviteit van vaccinatie tegen windpokken bij kinderen en tegen zona bij ouderen in België. / J Bilcke / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)
ISSN : D/2010/10.273/102 : € 0,00
Studie n° 2009-10
2011-01-24 (2nd print; 1st print: 2011-01-19<br>)
Languages : English (eng) Dutch (nla)
Descriptors: Indexation
2009-10 ; Chickenpox Vaccine ; Cost-Benefit Analysis ; Herpes Zoster Vaccine ; measles, mumps, rubella, varicella vaccine [Substance Name] ; R151
Classification
WC 571 Herpesviridae infections (General or not elsewhere classified)Abstract: Een vaccinatieprogramma van kinderen tegen windpokken, en van ouderen tegen zona, wat zouden de kosten en baten hiervan zijn? Deze vraag onderzocht het Centrum voor Gezondheidseconomie en Modellering van Infectieziekten (Universiteit Antwerpen) in opdracht van het Federaal Kenniscentrum voor de Gezondheidszorg (KCE). Een vaccinatieprogramma tegen windpokken kan best pas opgestart worden als men zeker is dat daardoor het aantal gevallen van zona niet tegelijkertijd te sterk toeneemt. Daarvoor moeten de resultaten in een aantal landen, die reeds met vaccinatie zijn gestart, worden afgewacht. Voor vaccinatie tegen zona van zestig plussers zijn er te weinig betrouwbare gegevens beschikbaar om de baten eenduidig in te schatten. Contents note: 1 GENERAL BACKGROUND 3 -- 1.1 CLINICAL MANIFESTATIONS 3 -- 1.2 TRANSMISSION 3 -- 2 DATA SOURCES AND INTERMEDIARY DATA ANALYSES 5 -- 2.1 DATA SOURCES 5 -- 2.1.1 MCD-HBD 5 -- 2.1.2 Carenet 5 -- 2.1.3 Surveys amongst NCSF members 6 -- 2.1.4 Child & Family survey 7 -- 2.1.5 Social contact patterns 7 -- 2.1.6 Serological surveys 7 -- 2.1.7 Flemish Agency for Care and Health 8 -- 2.1.8 Scientific Institute of Public Health (SIPH) 9 -- 2.1.9 Scott et al (2006) data 9 -- 2.1.10 Scientific literature 9 -- 2.2 HOSPITALISATIONS, PHYSICIAN CONSULTATIONS AND DEATHS DUE TO -- CHICKENPOX AND HERPES ZOSTER 10 -- 2.2.1 Hospitalisations due to CP and HZ 10 -- 2.2.2 Physician consultations due to CP and HZ 21 -- 2.2.3 Total number of people with CP and HZ 24 -- 2.2.4 Deaths due to CP and HZ 25 -- 2.2.5 Postherpetic neuralgia (PHN) 28 -- 2.2.6 HZ related burden-of-illness (BOI) 29 -- 2.3 COSTS RELATED TO CHICKENPOX AND HERPES ZOSTER 36 -- 2.3.1 Costs for people hospitalised for CP and HZ 36 -- 2.3.2 Cost for ambulatory care related to CP and HZ 42 -- 2.4 CP AND HZ RELATED LOSS IN QOL 48 -- 2.4.1 CP related loss in QoL 48 -- 2.4.2 HZ related loss in QoL 50 -- 2.5 BURDEN OF BREAKTHROUGH CP 52 -- 2.6 HZ IN IMMUNOCOMPETENT POPULATION 52 -- 2.7 USE OF ANTIVIRAL MEDICATION FOR HZ 54 -- 2.8 VACCINE RELATED CHARACTERISTICS 54 -- 2.8.1 Childhood VZV vaccination (“chickenpox” vaccination) 54 -- 2.8.2 Adult VZV booster vaccination (“herpes zoster” vaccination) 55 -- 3 COST-UTILITY ANALYSIS: METHODS 70 -- 3.1 VACCINATION OF ADULTS TO PREVENT HERPES ZOSTER 70 -- 3.1.1 Main outcome 70 -- 3.1.2 Mathematical model structure. 70 -- 3.1.3 Uncertainty and sensitivity analysis 71 -- 3.1.4 Overview tables of the estimated and assumed input parameters for the HZ model 72 -- 3.2 VACCINATION OF CHILDREN AGAINST PRIMARY VZV INFECTION 78 -- 3.2.1 Main outcome 78 -- 3.2.2 Mathematical model structure. 78 -- 3.2.3 Fitting to Belgian data 80 -- 3.2.4 Options for childhood VZV (CP) vaccination 82 -- 3.2.5 Overview tables of the estimated and assumed input parameters for the VZV model 83 -- 4 COST-UTILITY ANALYSIS: RESULTS 85 -- 4.1 VACCINATION AGAINST HZ: RESULTS. 85 -- 4.1.1 Clinical and economic impact of HZ vaccination 85 -- 4.1.2 Cost-utility of HZ vaccination 88 -- 4.2 PRIMARY VZV (CP) VACCINATION: RESULTS 93 -- 4.2.1 Impact of vaccination against CP (and HZ) assuming exogenous boosting 94 -- 4.2.2 Impact of vaccination against CP assuming no exogenous boosting 109 -- 5 DISCUSSION 113 -- 5.1 VACCINATION AGAINST HZ 113 -- 5.1.1 Comparison of our results with previous published CUA’s 116 -- 5.1.2 Strengths and weaknesses of our CUA of HZ booster vaccination in elderly compared -- to previously published CUA’s, with respect to: 117 -- 5.1.3 General conclusion 119 -- 5.2 VACCINATION AGAINST CP (AND HZ) 119 -- 5.2.1 Strengths and weaknesses of our CUA of VZV vaccination in children (and booster in adults) compared to previously published CUA’s 121 -- 6 APPENDICES 123 -- 7 REFERENCES 129 Link for e-copy: https://doi.org/10.57598/R151A Format of e-copy: PDF (2,9 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2326 Copies
Barcode Call number Media type Location Section Status No copy
ISSN : D/2010/10.273/103 : € 0,00
Etude n° 2009-10
2011-01-24 (2nd print; 1st print: 2011-01-19
Languages : English (eng) French (fre) Original Language : French (fre)
Descriptors: Indexation
2009-10 ; Chickenpox Vaccine ; Cost-Benefit Analysis ; Herpes Zoster Vaccine ; measles, mumps, rubella, varicella vaccine [Substance Name] ; R151
Classification
WC 571 Herpesviridae infections (General or not elsewhere classified)Abstract: Quels seraient les coûts et les bénéfices associés à des programmes de vaccination contre la varicelle chez les enfants et contre le zona chez les adultes ? Le Centre d’évaluation économique et de modélisation des maladies infectieuses de l’Université d’Anvers (CHERMID) a examiné ces questions pour le compte du Centre fédéral d’expertise des soins de santé (KCE). L’étude révèle qu’un programme de vaccination contre la varicelle n’est souhaitable que si l’on est certain qu’il n’engendrera pas d’augmentation trop importante du nombre de zonas. Les résultats, non encore disponibles, d’autres pays où la vaccination a déjà lieu devraient nous permettre d’en savoir plus. Les avantages de la vaccination des personnes âgées contre le zona ne sont pas clairs non plus à cause du manque actuel de données fiables. Contents note: 1 GENERAL BACKGROUND 3 -- 1.1 CLINICAL MANIFESTATIONS 3 -- 1.2 TRANSMISSION 3 -- 2 DATA SOURCES AND INTERMEDIARY DATA ANALYSES 5 -- 2.1 DATA SOURCES 5 -- 2.1.1 MCD-HBD 5 -- 2.1.2 Carenet 5 -- 2.1.3 Surveys amongst NCSF members 6 -- 2.1.4 Child & Family survey 7 -- 2.1.5 Social contact patterns 7 -- 2.1.6 Serological surveys 7 -- 2.1.7 Flemish Agency for Care and Health 8 -- 2.1.8 Scientific Institute of Public Health (SIPH) 9 -- 2.1.9 Scott et al (2006) data 9 -- 2.1.10 Scientific literature 9 -- 2.2 HOSPITALISATIONS, PHYSICIAN CONSULTATIONS AND DEATHS DUE TO -- CHICKENPOX AND HERPES ZOSTER 10 -- 2.2.1 Hospitalisations due to CP and HZ 10 -- 2.2.2 Physician consultations due to CP and HZ 21 -- 2.2.3 Total number of people with CP and HZ 24 -- 2.2.4 Deaths due to CP and HZ 25 -- 2.2.5 Postherpetic neuralgia (PHN) 28 -- 2.2.6 HZ related burden-of-illness (BOI) 29 -- 2.3 COSTS RELATED TO CHICKENPOX AND HERPES ZOSTER 36 -- 2.3.1 Costs for people hospitalised for CP and HZ 36 -- 2.3.2 Cost for ambulatory care related to CP and HZ 42 -- 2.4 CP AND HZ RELATED LOSS IN QOL 48 -- 2.4.1 CP related loss in QoL 48 -- 2.4.2 HZ related loss in QoL 50 -- 2.5 BURDEN OF BREAKTHROUGH CP 52 -- 2.6 HZ IN IMMUNOCOMPETENT POPULATION 52 -- 2.7 USE OF ANTIVIRAL MEDICATION FOR HZ 54 -- 2.8 VACCINE RELATED CHARACTERISTICS 54 -- 2.8.1 Childhood VZV vaccination (“chickenpox” vaccination) 54 -- 2.8.2 Adult VZV booster vaccination (“herpes zoster” vaccination) 55 -- 3 COST-UTILITY ANALYSIS: METHODS 70 -- 3.1 VACCINATION OF ADULTS TO PREVENT HERPES ZOSTER 70 -- 3.1.1 Main outcome 70 -- 3.1.2 Mathematical model structure. 70 -- 3.1.3 Uncertainty and sensitivity analysis 71 -- 3.1.4 Overview tables of the estimated and assumed input parameters for the HZ model 72 -- 3.2 VACCINATION OF CHILDREN AGAINST PRIMARY VZV INFECTION 78 -- 3.2.1 Main outcome 78 -- 3.2.2 Mathematical model structure. 78 -- 3.2.3 Fitting to Belgian data 80 -- 3.2.4 Options for childhood VZV (CP) vaccination 82 -- 3.2.5 Overview tables of the estimated and assumed input parameters for the VZV model 83 -- 4 COST-UTILITY ANALYSIS: RESULTS 85 -- 4.1 VACCINATION AGAINST HZ: RESULTS. 85 -- 4.1.1 Clinical and economic impact of HZ vaccination 85 -- 4.1.2 Cost-utility of HZ vaccination 88 -- 4.2 PRIMARY VZV (CP) VACCINATION: RESULTS 93 -- 4.2.1 Impact of vaccination against CP (and HZ) assuming exogenous boosting 94 -- 4.2.2 Impact of vaccination against CP assuming no exogenous boosting 109 -- 5 DISCUSSION 113 -- 5.1 VACCINATION AGAINST HZ 113 -- 5.1.1 Comparison of our results with previous published CUA’s 116 -- 5.1.2 Strengths and weaknesses of our CUA of HZ booster vaccination in elderly compared -- to previously published CUA’s, with respect to: 117 -- 5.1.3 General conclusion 119 -- 5.2 VACCINATION AGAINST CP (AND HZ) 119 -- 5.2.1 Strengths and weaknesses of our CUA of VZV vaccination in children (and booster in adults) compared to previously published CUA’s 121 -- 6 APPENDICES 123 -- 7 REFERENCES 129 Link for e-copy: http://doi.org/10.57598/R151B Format of e-copy: PDF (2,9 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2325 Copies
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Research Support, Non-U.S. Gov't
Languages : English (eng) German (ger)
in European journal of pediatrics > 167(2008)1 [01/01/2008] . - 47-55
Descriptors: Classification
W 1 Serials. Periodicals
Indexation
Adolescent ; Chickenpox ; Chickenpox Vaccine ; Child ; Child, Preschool ; Epidemiology ; Health Policy ; Hospitalization ; Humans ; Immunization Programs ; immunology ; Infant ; Journal Article ; Models, Theoretical ; Peer Review ; statistics and numerical data [Subheading]Abstract: Safe and effective vaccines against varicella zoster virus (VZV), the aetiological agent of varicella and shingles, have been available in Europe for the last 5-10 years. The USA has had a universal childhood vaccination policy since 1995 and this has resulted in a dramatic decrease in the incidence, morbidity and mortality related to varicella. The economic and medical burden of VZV has led to discussions regarding both the desirability and feasibility of a similar routine immunisation policy for all European children. This article examines the epidemiology of varicella in Europe and how the data emerging from the USA can be used to achieve adequate prevention of the disease. It looks into the current evidence of the health economic evaluation of universal varicella vaccination and explores the concerns surrounding such a policy, including the postulated impact on the incidence of zoster. In conclusion, the Society of Independent European Vaccination Experts (SIEVE) recommends that the immunisation of susceptible adolescents needs to be urgently implemented, in addition to the current recommendations targeting high-risk patients, their close contacts with a negative history of varicella and seronegative health-care workers. A universal policy, optimally incorporating a two-dose schedule, will be needed to finally reduce the burden of disease of varicella from a societal point of view. The SIEVE recommends the implementation of such a policy as soon as financially and practically possible. Link for e-copy: http://vdic.idm.oclc.org/login?url=http://www.springerlink.com/content/j51h56786 [...] Format of e-copy: VDIC IP recognition (200 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1765 [article]
