Cost-effectiveness of pentavalent meningococcal (MenABCWY) vaccination among adolescents in the United States

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-06-09 DOI:10.1016/j.vaccine.2025.127332

Xiaoyu Dong, Sarah F. Schillie, Lucy Alexandra McNamara, Andrew J. Leidner

{"title":"Cost-effectiveness of pentavalent meningococcal (MenABCWY) vaccination among adolescents in the United States","authors":"Xiaoyu Dong, Sarah F. Schillie, Lucy Alexandra McNamara, Andrew J. Leidner","doi":"10.1016/j.vaccine.2025.127332","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Invasive meningococcal disease (IMD) is a severe, acute illness associated with considerable mortality and long-term morbidity. In the United States, meningococcal serogroup A, C, W, and Y (MenACWY) vaccines and serogroup B (MenB) vaccines are used to prevent IMD among adolescents. GlaxoSmithKline has developed a new pentavalent (MenABCWY) vaccine, covering all five serogroups: A, B, C, W, and Y, with licensure in spring 2025. The Advisory Committee on Immunization Practices (ACIP) has been considering three options regarding use of MenABCWY in the context of the existing immunization schedule, which consists of two routine doses of MenACWY, and two doses of MenB under shared clinical decision-making.</div></div><div><h3>Methods</h3><div>This study evaluated the cost-effectiveness of the pentavalent vaccine in adolescents using a population-based model that includes all current 11-year-olds in the United States. We analyzed vaccination strategies over a 19-year period, updating every six months to reflect changes in vaccination coverage, disease incidence and mortality, and costs. We used a lifetime analytic horizon to evaluate outcomes that extend beyond this period, including costs and quality-adjusted life years due to sequelae. The main summary measure was the incremental cost-effectiveness ratio (ICER), calculated as costs per quality-adjusted life year (QALY) gained. Costs were reported in US$2024 and all future values were discounted by 3 % annually.</div></div><div><h3>Results</h3><div>The ICERs varied from being cost-saving when one dose of MenABCWY replaced concurrent administration of MenACWY and MenB, to costing $11,334,294 per QALY gained when two-doses of MenABCWY replaced the two-dose MenACWY regimen. The ICER was most sensitive to the cost of pentavalent vaccine.</div></div><div><h3>Conclusion</h3><div>Using the pentavalent vaccine as an alternative to the simultaneous administration of MenACWY and MenB was cost-saving, but other uses are more costly. Further analyses of other adolescent vaccination schedules are warranted to explore opportunities for cost-effective IMD prevention.</div></div>","PeriodicalId":23491,"journal":{"name":"Vaccine","volume":"61 ","pages":"Article 127332"},"PeriodicalIF":4.5000,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vaccine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0264410X25006292","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Invasive meningococcal disease (IMD) is a severe, acute illness associated with considerable mortality and long-term morbidity. In the United States, meningococcal serogroup A, C, W, and Y (MenACWY) vaccines and serogroup B (MenB) vaccines are used to prevent IMD among adolescents. GlaxoSmithKline has developed a new pentavalent (MenABCWY) vaccine, covering all five serogroups: A, B, C, W, and Y, with licensure in spring 2025. The Advisory Committee on Immunization Practices (ACIP) has been considering three options regarding use of MenABCWY in the context of the existing immunization schedule, which consists of two routine doses of MenACWY, and two doses of MenB under shared clinical decision-making.

Methods

This study evaluated the cost-effectiveness of the pentavalent vaccine in adolescents using a population-based model that includes all current 11-year-olds in the United States. We analyzed vaccination strategies over a 19-year period, updating every six months to reflect changes in vaccination coverage, disease incidence and mortality, and costs. We used a lifetime analytic horizon to evaluate outcomes that extend beyond this period, including costs and quality-adjusted life years due to sequelae. The main summary measure was the incremental cost-effectiveness ratio (ICER), calculated as costs per quality-adjusted life year (QALY) gained. Costs were reported in US$2024 and all future values were discounted by 3 % annually.

Results

The ICERs varied from being cost-saving when one dose of MenABCWY replaced concurrent administration of MenACWY and MenB, to costing $11,334,294 per QALY gained when two-doses of MenABCWY replaced the two-dose MenACWY regimen. The ICER was most sensitive to the cost of pentavalent vaccine.

Conclusion

Using the pentavalent vaccine as an alternative to the simultaneous administration of MenACWY and MenB was cost-saving, but other uses are more costly. Further analyses of other adolescent vaccination schedules are warranted to explore opportunities for cost-effective IMD prevention.

查看原文本刊更多论文

美国青少年接种五价脑膜炎球菌（menabcy）疫苗的成本效益

背景：侵袭性脑膜炎球菌病（IMD）是一种严重的急性疾病，具有相当高的死亡率和长期发病率。在美国，脑膜炎球菌血清A、C、W和Y （MenACWY）疫苗和血清B （MenB）疫苗被用于预防青少年IMD。葛兰素史克（GlaxoSmithKline）开发了一种新的五价（menabcy）疫苗，覆盖所有五个血清群：a、B、C、W和Y，并于2025年春季获得许可。免疫实践咨询委员会（ACIP）一直在考虑在现有免疫计划的背景下使用MenABCWY的三种选择，该计划包括两剂常规剂量的MenACWY和两剂共同临床决策的MenB。方法本研究使用基于人群的模型评估了五价疫苗在青少年中的成本效益，该模型包括美国所有目前11岁的儿童。我们分析了19年期间的疫苗接种策略，每6个月更新一次，以反映疫苗接种覆盖率、疾病发病率和死亡率以及成本的变化。我们使用终身分析视界来评估超出这一时期的结果，包括成本和由于后遗症引起的质量调整寿命年。主要的综合测量是增量成本-效果比（ICER），以每个质量调整生命年（QALY）获得的成本计算。报告成本为2024美元，所有未来价值每年折现3%。结果：当一剂MenABCWY替代MenACWY和MenB同时给药时，ICERs节省了成本，而当两剂MenABCWY替代两剂MenACWY方案时，ICERs每QALY花费11,334,294美元。ICER对五价疫苗的价格最为敏感。结论使用五价疫苗替代MenACWY和MenB同时接种可节省成本，但其他使用成本较高。有必要进一步分析其他青少年疫苗接种时间表，以探索具有成本效益的IMD预防机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.