Cost-effectiveness analyses of monovalent mumps vaccination programs for Japanese children

Shu-Ling Hoshi; Reiko Okubo; Keiji Tabuchi; Xerxes Seposo; Aiko Shono; Masahide Kondo

doi:10.1016/j.vaccine.2022.08.004

Cost-effectiveness analyses of monovalent mumps vaccination programs for Japanese children

Vaccine. 2022 Sep 2;40(37):5513-5522. doi: 10.1016/j.vaccine.2022.08.004. Epub 2022 Aug 12.

Authors

Shu-Ling Hoshi¹, Reiko Okubo², Keiji Tabuchi³, Xerxes Seposo⁴, Aiko Shono⁵, Masahide Kondo⁶

Affiliations

¹ Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577 Japan. Electronic address: hoshi@hcs.tsukuba.ac.jp.
² Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577 Japan; Department of Clinical Laboratory Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
³ Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Tsukuba, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058576 Japan.
⁴ School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
⁵ Laboratory of Social Pharmacy and Regulatory Science, Showa Pharmaceutical University, Machida, Tokyo 194-8543, Japan.
⁶ Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki 3058577 Japan.

PMID: 35965241
DOI: 10.1016/j.vaccine.2022.08.004

Abstract

Background: The most common preventative measure against mumps is vaccination with mumps vaccine. Over 122 countries have implemented mumps vaccine routine immunization programs, mostly via Measles-Mumps-Rubella (MMR) vaccine. In Japan, the unexpectedly high incidence of aseptic meningitis caused by mumps vaccine led to the discontinuation of the MMR national vaccination program in 1993, inadvertently resulting in the re-emergence of mumps. Plans of introducing monovalent mumps vaccine into routine vaccination schedule have become one of the emerging topics in health policy that has warranted the need in evaluating its value for money.

Methods: We conducted cost-effectiveness analyses with Markov model and calculated incremental cost-effectiveness ratios (ICERs) of two different vaccination programs (a single-dose program at one-year-old, a two-dose program with second dose uptakes at five) compared to status quo from both payers' and societal perspectives. Transition probabilities and utility weights in estimating quality-adjusted life-year (QALY), and disease treatment costs were either estimated or obtained from literature. Costs per vaccination were assumed at ¥6140 (US$58;1US$ = ¥106).

Results: Both programs reduce disease treatment costs compared to status quo, while the reduction cannot offset vaccination cost. ICER of either program is found to be under ¥5,000,000 (US$47,170)/QALY willingness-to-pay (WTP) threshold from either perspective. Results of probabilistic sensitivity analyses expressed by net monetary benefit indicated that at the WTP threshold, the acceptability is at 92.6% for two-dose vaccination program, 0% for single-dose vaccination program, and 7.4% for current no vaccination program. Two-dose program was optimal among the alternatives. One-way sensitivity analyses revealed that proportion of mumps-related hearing loss among mumps cases and vaccine effectiveness (VE) were key variables in changing the ICERs.

Conclusion: Routine vaccination program of single- and two-dose programs were cost-effective from both payers' and societal perspectives. Between the two, the two-dose vaccination program was observed to be more favorable.

Keywords: Cost-effectiveness; Economic evaluation; Mumps; Mumps vaccine; Quality-adjusted life year; Vaccination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Cost-Benefit Analysis
Humans
Immunization Programs
Infant
Japan / epidemiology
Measles-Mumps-Rubella Vaccine
Mumps* / epidemiology

Substances

Measles-Mumps-Rubella Vaccine