Cost-Effectiveness Analysis of Routine Immunization for Varicella in Japan

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Other Title
  • 水痘ワクチン定期接種化の費用対効果分析
  • スイトウ ワクチン テイキ セッシュカ ノ ヒヨウ タイ コウカ ブンセキ

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Abstract

Objective: Immunization for varicella is not currently included in routine immunizations in Japan. Thisstudy was conducted to assess test its cost-effectiveness when it becomes a routine.<BR>Methods: We surveyed and collected information for the year beginning 15th June 2004 in one area.Almost all 11 pediatric clinics or hospitals in the area cooperated in this survey. There was a questionnaireform for families and for doctors. Absent days from routine tasks, i.e., job, housekeeping or study, for familynursing and others were asked on family form. Medical costs and other costs were asked on doctor form.Neither form included the patient's name or name of the medical institution. Doctors explained this surveyto patients' family on their first visiting day and asked to cooperate. If they refused the doctor form was also discarded. Since family form was written after recovery and mailed, cooperation in this survey was voluntary.Opportunity cost for family nursing is estimated as opportunity cost based on the 2002 Basic Surveillance of Wage Structure. The burden of sequel cases was estimated assuming six million yen per Quality-adjusted Life Years (QALY). Total number of patients was estimated to be 0.84 million, which includes unvaccinated people in a birth cohort. We adopted incremental benefit cost ratios form societal viewpointas a measure.<BR>Results: We collected 402 data from the doctor form and 265 from the family form. Total disease burden in all of Japan is estimated to be 52.2 billion yen, but opportunity cost accounted for 80%. The incremental benefit cost rations averaged more than 4 when vaccination cost is assumed to be five to twelve thousand yen. The lower limit of the confidence intervals is about 1.5.<BR>Discussion and Conclusion: The disease burden of varicella was greater than measles in 2000, when there were measles 0.2 million patients. The incremental benefit cost ratio showed that there will almost surely be an additional benefit due to routine immunization is greater than the additional cost. Therefore, we found strong evidence for routine immunization for varicella.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 80 (3), 212-219, 2006

    The Japanese Association for Infectious Diseases

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