Modelling the cost-effectiveness of new meningococcal vaccines in England

Objectives New meningococcal vaccines able to protect against serogroup B disease are expected to go to licensure shortly. Vaccine policy makers will soon be faced with a decision about if and how to introduce these vaccines. This study uses a cohort model to predict the potential impact of introducing a new meningococcal vaccine in England. Methods A probabilistic age structured cohort model of meningococcal disease and vaccination was developed, following a hypothetical 2008 birth cohort over their lifetime (100 years). Epidemiological parameters and the costs of meningococcal disease and vaccination to the health service were estimated from available data; future costs and benefits were discounted back to 2008 (HM Treasury recommendations). A number of routine and catch-up vaccination strategies were simulated. Vaccines were assumed to provide direct protection only. Results Preliminary results from the baseline model (vaccination at 2,3,4+12 months of age, 75% effective vaccine coverage, 24 months average protection following booster, £40 per vaccine dose) indicate introduction of an infant routine schedule is highly unlikely to be cost effective (>£100,000 per QALY gained). Catch-up campaigns in 1-4 or 1-17 year olds are also unlikely to be cost-effective. The results are sensitive to changes in disease incidence, proportion of cases with sequelae, vaccine cost and vaccine duration of protection. Conclusion Introduction of the new meningococcal vaccines is unlikely to be cost-effective in England, given current disease levels. Models allowing for herd immunity may reach different conclusions, however it is currently unknown whether these new vaccines will provide protection against carriage.