COST-EFFECTIVENESS OF INTRODUCING MUMPS-CONTAINING VACCINATION FOR CHILDREN IN JAPAN
Author(s)
Shunya Ikeda, MSc, PhD, MD1, Yuriko Hagiwara, BSc, MSc, PhD2, Ayako Shoji, PhD2, Hiroshi Yoshihara, BS, MS2, Ataru Igarashi, PhD2.
1Professor of Public Health, International University of Health and Welfare/Keio University, Tokyo, Japan, 2Keio University, Tokyo, Japan.
1Professor of Public Health, International University of Health and Welfare/Keio University, Tokyo, Japan, 2Keio University, Tokyo, Japan.
OBJECTIVES: In Japan, mumps vaccine is not included in the routine immunization program, although mumps can cause meningitis, orchitis, pancreatitis, encephalitis, and permanent hearing loss. This study evaluated the cost-effectiveness of introducing mumps-containing vaccination for children in Japan.
METHODS: A model compared three strategies: measles-rubella (MR) vaccination only, concomitant administration of monovalent mumps vaccine with MR vaccine, and measles-mumps-rubella (MMR) vaccination. Vaccination was assumed at 12-23 months and again in the preschool year. Analyses were conducted from the health-care payer and societal perspectives. The model incorporated age- and sex-specific mumps incidence, complication rates, medical costs, productivity losses, mortality, and quality-adjusted life-year (QALY) losses from acute illness and sequelae, including encephalitis and unilateral or bilateral hearing loss. Vaccine effectiveness was based primarily on meta-analytic evidence: 72% after one dose and 86% after two doses, with annual waning of 3.9% and 1.6%, respectively. Costs and outcomes were discounted at 2%, with one-way sensitivity analyses varying vaccine effectiveness, waning, utility loss, medical costs, vaccine price, and discount rate.
RESULTS: From the health-care payer perspective, adding monovalent mumps vaccine to MR increased costs by ¥8,659 and gained 0.004064 QALYs compared with MR alone, yielding an incremental cost-effectiveness ratio (ICER) of ¥2.13 million/QALY. MMR vaccination generated the same QALY gain but increased costs by ¥23,496, resulting in an ICER of ¥5.78 million/QALY. From the societal perspective, monovalent mumps vaccination was dominant, reducing costs by ¥6,218 while improving QALYs. MMR vaccination produced an ICER of ¥84,000/QALY. Sensitivity analyses showed that results were most influenced by the discount rate and vaccine effectiveness, but societal-perspective results remained highly favorable.
CONCLUSIONS: Introducing mumps-containing vaccination for Japanese children is likely to be cost-effective, particularly when productivity losses are considered. These findings support policy consideration of routine national mumps vaccination in Japan as a potential component of routine immunization policy.
METHODS: A model compared three strategies: measles-rubella (MR) vaccination only, concomitant administration of monovalent mumps vaccine with MR vaccine, and measles-mumps-rubella (MMR) vaccination. Vaccination was assumed at 12-23 months and again in the preschool year. Analyses were conducted from the health-care payer and societal perspectives. The model incorporated age- and sex-specific mumps incidence, complication rates, medical costs, productivity losses, mortality, and quality-adjusted life-year (QALY) losses from acute illness and sequelae, including encephalitis and unilateral or bilateral hearing loss. Vaccine effectiveness was based primarily on meta-analytic evidence: 72% after one dose and 86% after two doses, with annual waning of 3.9% and 1.6%, respectively. Costs and outcomes were discounted at 2%, with one-way sensitivity analyses varying vaccine effectiveness, waning, utility loss, medical costs, vaccine price, and discount rate.
RESULTS: From the health-care payer perspective, adding monovalent mumps vaccine to MR increased costs by ¥8,659 and gained 0.004064 QALYs compared with MR alone, yielding an incremental cost-effectiveness ratio (ICER) of ¥2.13 million/QALY. MMR vaccination generated the same QALY gain but increased costs by ¥23,496, resulting in an ICER of ¥5.78 million/QALY. From the societal perspective, monovalent mumps vaccination was dominant, reducing costs by ¥6,218 while improving QALYs. MMR vaccination produced an ICER of ¥84,000/QALY. Sensitivity analyses showed that results were most influenced by the discount rate and vaccine effectiveness, but societal-perspective results remained highly favorable.
CONCLUSIONS: Introducing mumps-containing vaccination for Japanese children is likely to be cost-effective, particularly when productivity losses are considered. These findings support policy consideration of routine national mumps vaccination in Japan as a potential component of routine immunization policy.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE292
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Disease
Vaccines