OBJECTIVES:

Varicella is estimated to cause over 60,000 cases annually in Denmark, which does not include universal varicella vaccination (UVV) in the national immunization program (NIP). This study estimated the economic burden of varicella in the absence of UVV and the potential cost of including varicella vaccination in the NIP.

METHODS:

A systematic literature review was conducted to obtain country-specific unit cost per varicella case and associated healthcare resource utilization. The number of annual varicella cases, deaths, outpatient visits and hospitalizations were calculated based on age-specific incidence rates (Riera-Montes et al. 2017) and 2018 population data. A predictive model using stochastic simulation (10,000 iterations) was used to estimate the 2018 total costs (direct and indirect) stratified by age and healthcare resource utilization. We estimated cost of a 2-dose monovalent varicella NIP (1^st dose at 15 months and 2^nd dose at 4 years, same schedule as MMR) using published list prices of MSD’s varicella vaccine.

RESULTS:

Without vaccination, annual total costs associated with varicella disease in Denmark were estimated to be 7.23 million Euros (M€). Direct and indirect annual costs were estimated at M€ 2.58 (2.36 – 2.80) and M€4.65 (4.03 – 5.27), respectively. Majority of costs were attributed to caregiver work loss (51%) followed by primary care visits (19%). The estimated annual cost of including varicella vaccine in the NIP for the first 3 years was M€ 3.42 and doubled (M€ 6.44) after 4 years due to 2^nd dose implementation.

CONCLUSIONS:

In the absence of UVV, the economic burden of varicella in Denmark is substantial. The estimated annual cost of a 2-dose varicella vaccine is lower than the estimated annual economic burden of disease. UVV could reduce the disease and economic burden associated with varicella in Denmark.