Pharmacoeconomic analysis of pertussis booster dose in adolescents in Bulgaria

Abstract

Pertussis, commonly known as ‘whooping cough’, can affect all age groups and occurs at any time during the year. The aim was to estimate the current health and economic burden of pertussis-associated disease in Bulgaria. We also analyzed the cost-benefit and financial consequences of introducing (since 1st January 2020) an acellular pertussis (acP) booster dose at the age of 12 into the immunization schedule of Bulgaria. A combined pharmacoeconomic (cost-benefit and budget impact analysis) and a population-based screening cohort study was performed. It included 202 women in reproductive age (20 to 39 years). Fifty-one percent had only one child and 49% had two or more children. Over 70% of all the 202 women had an average of 3.75 IU/mL IgG-anti-PT (indication for waning pertussis protection) and 1.5% had >100 IU/mL IgG-anti-PT, which indicate a recent infection. Bulgaria has low pertussis morbidity, as the reported cases are limited, compared to the the average in the European Union and there have been no death cases in the last 10 years. However, significant pertussis infections remain unreported but still occur in the adult population. An acP booster dose, at the age of 12, was projected to give significant potential savings from the reduced number of physician and hospitalization visits, ambulatory care and indirect costs. The budget impact of a booster dose was expected to decrease from 4.45 million BGN to 3.9 million BGN. The acP booster dose would lead annually to around 4.2 million BGN and avoid the active cases with seven.