Abstract

The mumps vaccine is not included in the national immunisation programme (NIP) of approximately 80 countries including Japan. To investigate the vaccine's cost-effectiveness, we developed a dynamic transmission model for routine one- and two-dose mumps vaccination programs in Japan. We calculated the incremental cost-effectiveness ratio compared with a current programme over a projected 50-year period. We created a Japanese population model and performed dynamic simulation to estimate the number of patients enrolled in the current programme, the routine one-dose programme, and the routine two-dose programme over the next 50 years using the Berkeley Madonna program. We estimated the medical and social costs of natural mumps infections and vaccinations to analyse cost-effectiveness. Finally, we performed a sensitivity analysis with parameters including vaccine cost, vaccine efficacy, medical costs per case, social costs per case, incidence of adverse events and discount rate. Base case analysis showed that both the one-dose and two-dose programmes predominated and that quality-adjusted life years (QALYs) were saved, compared with the current programme. The medical costs, total cost and QALYs saved during the study period in the two-dose programme compared with the current programme were 217 billion JPY, 860 billion JPY and 184 779, respectively. The two-dose programme surpassed the one-dose programme throughout the study period. In all the scenarios of the sensitivity analysis, two-dose vaccination was better than the one-dose programme. This simulation confirmed that the routine two-dose vaccination programme was more cost-effective and QALY-saving than either the one-dose programme or the current programme. Because of the variability of the results between the various models, further simulations with different models should be conducted.

Highlights

  • Two-dose mumps vaccine programmes are an integral part of their national immunisation programmes (NIP)

  • In Japan, the mumps vaccine has been excluded from the NIP because of vaccine-induced aseptic meningitis [2]

  • We found significant cost and quality-adjusted life years (QALYs) savings in the routine two-dose programme

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Summary

Introduction

Two-dose mumps vaccine programmes are an integral part of their national immunisation programmes (NIP). The annual number of mumps infection in Japan is estimated to be from 400 000 to 1 500 000 with inconsequential number of mumps-induced complications such as meningitis, encephalitis, hearing loss, orchitis and oophoritis [5]. This mumps epidemic is causing significant burdens for patients and for their families because most of mumps patients are children, and their parents need to take care of them. It leads to billions of medical and social costs each year in addition to loss of healthy lives [5]

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