Presentation (CTI)

OBJECTIVES: The Measles Mumps Rubella (MMR) vaccine has been introduced in the routine immunization schedule of over 122 countries. In India, the MMR vaccine is not included in the routine immunisation schedule. In the universal immunisation programme, only measles and rubella (MR) vaccine is given to children. Recent focal outbreaks of mumps among children in Kerala state, India highlighted the need for inclusion of the MMR vaccine in the immunisation schedule. To determine the cost-effectiveness of MMR vaccine from the Indian provider perspective, we undertook the study from the Indian provider perspective.
METHODS: A decision-tree model was used to predict the lifetime costs and outcomes. The intervention was Jeryl Lynn (JL) mumps strain in the MMR vaccine. The comparator was the routine MR vaccination to the study population (children). A discounting rate of 3% was applied for the costs, QALYs and cases averted for the lifetime of a patient (70 years).
RESULTS: The ICER per mumps case averted was found to be ₹1,890.36 and the ICER per QALY gained was found to be ₹2,746.25, for the JL strain mumps vaccine. The one-way sensitivity analysis depicted that the cost of vaccine, mumps infection probability, and symptomatic probability, exhibited the strongest influence on the upper and lower limits of the ICER. In case of probabilistic sensitivity analysis, all the iterations of the ICER per mumps cases averted lied below the WTP threshold, which is one GDP per capita of India of ₹2,30,000/-.
CONCLUSIONS: The introduction of the JL strain mumps vaccine in the current MR immunization schedule for children is found to be a cost-effective intervention. The incremental cost of introduction of MMR vaccines in the place of the current MR vaccines is found to be below the ICER threshold for the country.