WEKO3
アイテム
Cost-effectiveness analysis of maternal vaccination against Group B streptococcus in Japan
http://hdl.handle.net/10069/0002000073
http://hdl.handle.net/10069/0002000073dfb9bd9c-8def-4351-8674-0de96bbcc465
| ライセンス | アクション | |
|---|---|---|
VX14_100332.pdf (1.3 MB)
|
|
| Item type | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023-07-25 | ||||||||||||
| タイトル | ||||||||||||
| en | ||||||||||||
| タイトル | Cost-effectiveness analysis of maternal vaccination against Group B streptococcus in Japan | |||||||||||
| eng | ||||||||||||
| キーワード | ||||||||||||
| en | ||||||||||||
| Other | ||||||||||||
| Group B streptococcus (GBS) | ||||||||||||
| キーワード | ||||||||||||
| en | ||||||||||||
| Other | ||||||||||||
| Vaccine|Maternal immunization | ||||||||||||
| キーワード | ||||||||||||
| en | ||||||||||||
| Other | ||||||||||||
| Cost-effectiveness analysis | ||||||||||||
| キーワード | ||||||||||||
| en | ||||||||||||
| Other | ||||||||||||
| Neonatal sepsis | ||||||||||||
| キーワード | ||||||||||||
| en | ||||||||||||
| Other | ||||||||||||
| Neonatal meningitis | ||||||||||||
| http://purl.org/coar/resource_type/c_6501 | ||||||||||||
| journal article | ||||||||||||
Sorano, Sumire
× Sorano, Sumire
× Procter, Simon R
× Seale, Anna C
|
||||||||||||
| Abstract | ||||||||||||
| 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 outcomes would increase health benefits and cost-effectiveness. | ||||||||||||
| en | ||||||||||||
|
en : Vaccine: X |
||||||||||||
| en | ||||||||||||
| Elsevier Ltd | ||||||||||||
| ISSN | ||||||||||||
| ISSN | ||||||||||||
| 25901362 | ||||||||||||
| DOI | ||||||||||||
| isIdenticalTo | ||||||||||||
| DOI | ||||||||||||
| 10.1016/j.jvacx.2023.100332 | ||||||||||||
| en | ||||||||||||
| ⓒ 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/). | ||||||||||||
| VoR | ||||||||||||
| http://purl.org/coar/version/c_970fb48d4fbd8a85 | ||||||||||||
| Other | ||||||||||||
| Vaccine: X, 14, art. no. 100332; 2023 | ||||||||||||
| en | ||||||||||||
