Cost-benefit model comparing two alternative immunisation programmes against serogroup C XXXX : for Quebec residents aged 2 months to 20 years.

@entity3928 @entity204 @entity7135
OBJECTIVE: To evaluate the most efficient approach to managing an outbreak of serogroup C @entity7135 . An early planned @entity3928 ( @entity3928 ) was compared with a delayed programme implemented at the peak of a meningococcal outbreak. DESIGN AND SETTING: A cost-benefit model was constructed of meningococcal cases reported in Quebec, Canada, from 1990-1993, before and after the @entity3928 , during the winter of 1992-1993, when 84% of residents aged 6 months to 20 years were vaccinated. Epidemiological data from 1990-1993 were transposed to 2002-2003 under the assumption that Quebec is on the brink of an identical outbreak cycle. All Quebec residents aged 2 months to 20 years were assumed to be vaccinated, which required a total of 1.7 million doses of conjugated vaccine. Clinical and economic outcomes of both vaccination scenarios were compared. All costs were transformed to 2001 Canadian dollars ( Can), at an annual inflation rate of 3%. Future earnings due to @entity204 were discounted at 5% per year with a 3% increase in wages per year and a 9% unemployment rate. PERSPECTIVE: Ministry of Health and society. MAIN OUTCOME MEASURES: The number of new cases avoided and the prevention of hospital and societal costs due to @entity7135 -attributed premature mortality and morbidity, and direct costs associated with implementation of a @entity3928 . RESULTS: When compared with a delayed @entity3928 over a 14-month period, an early planned @entity3928 would have prevented 112 new cases of @entity7135 (16 deaths, 21 major complications) while saving   Can 37.1 million in total direct costs to the Ministry of Health and an additional   Can 17.4 million in societal costs in the province of Quebec. CONCLUSION: An early planned @entity3928 implemented in Quebec in September 2001, should be cost beneficial compared with delaying mass immunisation until a meningococcal outbreak is underway. Although this conclusion is limited by the assumption that epidemiological trends in 2001 in absence of a @entity3928 would have been similar to that observed in the early 1990s prior to the @entity3928 , the analysis still indicates that an early @entity3928 in the 1990s would have been cost beneficial compared with a delayed @entity3928 .
