VZV Foundation - A Decade Of Leadership In The Fight Against VZV Infections

	Oral Presentation Abstracts: 55 [55] COST-EFFECTIVENESS OF VARICELLA VACCINATION IN CANADA *M. Brisson (1,2), W.J. Edmunds (1,2) (1) PHLS Communicable Disease Surveillance Centre, London, UK; (2) City University, London, UK With the licensing of the varicella vaccine in many countries and its introduction into the immunisation schedule of the US, there is now much interest in the cost-effectiveness of varicella vaccination in developed countries. The objective of this study was to evaluate the cost-effectiveness of routine varicella immunization in Canadian children taking into account the possible impact of zoster and breakthrough varicella. A deterministic realistic age-structured model was used to predict the impact of vaccination on the incidence of varicella and zoster. Unit costs, estimated from literature, were applied to the predicted health outcomes. Various vaccination programs were investigated and a sensitivity analyses was performed. Under base case assumptions the cost per life-year gained of varicella vaccination is estimated to be $45,000, $32,000 and $18,000 per life-year gained from the health payer's perspective for infant, infant with catch-up campaign and preteen programs respectfully. From the societal perspective, mass infant varicella vaccination was estimated to be highly cost saving in Canada under a wide range of plausible parameter values. Importantly, infant varicella vaccination could cause a temporary increase in the incidence of zoster (due to a loss of boosting from varicella infection) in which case varicella vaccination would not be cost-effective ($118,000 per life-year gained under the health payer's perspective). Breakthrough varicella did not have a significant impact on results. In conclusion, routine varicella vaccination could, under certain conditions, be cost-effective for the health payer and is likely to be cost saving from the societal perspective. However, if varicella vaccination increases zoster incidence then infant varicella vaccination is unlikely to be cost-effective from the health payer's perspective. Corresponding Author: M. Brisson, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, United Kingdom

[55]

COST-EFFECTIVENESS OF VARICELLA VACCINATION IN CANADA

*M. Brisson (1,2), W.J. Edmunds (1,2)
(1) PHLS Communicable Disease Surveillance Centre, London, UK; (2) City University, London, UK

With the licensing of the varicella vaccine in many countries and its introduction into the immunisation schedule of the US, there is now much interest in the cost-effectiveness of varicella vaccination in developed countries. The objective of this study was to evaluate the cost-effectiveness of routine varicella immunization in Canadian children taking into account the possible impact of zoster and breakthrough varicella. A deterministic realistic age-structured model was used to predict the impact of vaccination on the incidence of varicella and zoster. Unit costs, estimated from literature, were applied to the predicted health outcomes. Various vaccination programs were investigated and a sensitivity analyses was performed. Under base case assumptions the cost per life-year gained of varicella vaccination is estimated to be $45,000, $32,000 and $18,000 per life-year gained from the health payer's perspective for infant, infant with catch-up campaign and preteen programs respectfully. From the societal perspective, mass infant varicella vaccination was estimated to be highly cost saving in Canada under a wide range of plausible parameter values. Importantly, infant varicella vaccination could cause a temporary increase in the incidence of zoster (due to a loss of boosting from varicella infection) in which case varicella vaccination would not be cost-effective ($118,000 per life-year gained under the health payer's perspective). Breakthrough varicella did not have a significant impact on results. In conclusion, routine varicella vaccination could, under certain conditions, be cost-effective for the health payer and is likely to be cost saving from the societal perspective. However, if varicella vaccination increases zoster incidence then infant varicella vaccination is unlikely to be cost-effective from the health payer's perspective.

Corresponding Author: M. Brisson, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, United Kingdom