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Cost-effectiveness analysis of maternal vaccination against Group B streptococcus in Japan

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  • معلومة اضافية
    • بيانات النشر:
      Elsevier Ltd
    • الموضوع:
      2023
    • Collection:
      NAOSITE: Nagasaki University Academic Output SITE / 長崎大学 学術研究成果リポジトリ
    • نبذة مختصرة :
      Background: Group B Streptococcus (GBS) is a leading pathogen causing life-threatening bacterial infections in neonates (early- or late-onset) and infants, and is associated with preterm and stillbirth. Japan introduced national guidelines to reduce early-onset neonatal GBS disease, with universal prenatal screening and intrapartum antimicrobial prophylaxis (IAP). However, screening/IAP does not prevent GBS associated late-onset disease, preterm or stillbirth. Maternal GBS vaccines in development are targeted at infant GBS disease but may provide benefit across perinatal outcomes. We aimed to assess cost-effectiveness of a future maternal GBS vaccine, for a base case prevention of infant GBS disease in combination with screening/IAP compared to screening/IAP alone. Methods: We used a decision tree model to estimate cases of infant GBS disease, deaths, and neurodevelopmental impairment (NDI), GBS-related stillbirths, and the associated costs and loss in Quality-Adjusted Life Years (QALYs). We calculate the threshold price at which a vaccine would be costeffective assuming a cost-effectiveness threshold of ¥5 million/QALY. We explored the potential benefit of a maternal GBS vaccine that also prevents preterm birth in a scenario analysis. Results: Maternal GBS vaccination in Japan could prevent an additional 142 infant GBS cases annually, including 5 deaths and 21 cases of NDI, and 13 stillbirths compared to screening/IAP alone. The incremental cost-effectiveness ratio (ICER) was ¥3.78 million/QALY with a vaccine cost of ¥5,000/dose. If the QALY lost for stillbirth is included, the ICER is reduced to ¥1.78 million/QALY. Median threshold vaccine price was ¥6,900 per dose (95 % uncertainty interval ¥5,100 to ¥9,200 per dose). If maternal GBS vaccination also prevented half of GBS-associated preterm, the ICER would be reduced to ¥1.88 million/QALY. Conclusions: An effective maternal GBS vaccine is likely to be considered cost-effective in Japan at a price of ¥5,000/dose. Effectiveness against other adverse perinatal ...
    • File Description:
      application/pdf
    • ISSN:
      25901362
    • Relation:
      Vaccine: X; 14; art. no. 100332; https://nagasaki-u.repo.nii.ac.jp/record/2000073/files/VX14_100332.pdf
    • الدخول الالكتروني :
      https://nagasaki-u.repo.nii.ac.jp/record/2000073/files/VX14_100332.pdf
    • Rights:
      ⓒ 2023 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
    • الرقم المعرف:
      edsbas.F3BDDCDC