Varicella Vaccine, Cost-Effectiveness Analyses and Vaccination Policy
Childhood and Adolescent Vaccines
In an accompanying editorial, Matthew M. Davis, M.D., M.A.P.P., of the University of Michigan, Ann Arbor, comments on the study by Zhou et al.
"...these findings do not conclusively confirm that childhood varicella vaccination is as cost-effective as originally anticipated, for several reasons. First, the cost of the vaccine has increased more than $10 per dose in inflation-adjusted terms since 1995 (the current public sector price per dose is $52.25), although an increase of this magnitude was not anticipated to change the cost-effectiveness dramatically. Second, the national varicella vaccine recommendation prompted states to measure and react to varicella as a reportable vaccine-preventable illness. The costs of such monitoring and of responding to outbreaks of varicella (e.g., in day care or school settings) may be substantial and were not included in the original analysis [in another study]."
"Third, and perhaps most important, there is great uncertainty about the extent to which parents and other adults experienced reductions in lost work time attributable to varicella. As with other childhood and adolescent vaccines that have recently been recommended (e.g., pneumococcal and meningococcal conjugate vaccines), indirect cost savings with varicella vaccine were expected to be larger than savings in direct medical costs."
"To maximize the benefits of vaccines for children and adults in the future, it is imperative to formally and openly consider how best to incorporate cost-effectiveness considerations into deliberations about vaccine recommendations, thereby acknowledging that health and economics cannot be teased apart. From the perspectives of patients, payers, clinicians, and public health officials, costs are just as much a part of vaccines as their benefits," Dr. Davis concludes.