Economic Evaluation of the Pediatric Immunization Program in Belgium


Carrico J1, Mellott CE2, Talbird SE2, Abreu A3, Merckx B4, Vandenhaute J4, Benchabane D4, Dauby N5, Ethgen O6, Lepage P7, Luyten J8, Raes M9, Simoens S8, Van Ranst M8, Bencina G10, Nyaku MK11
1RTI Health Solutions, Apex, NC, USA, 2RTI Health Solutions, Research Triangle Park, NC, USA, 3MSD, Brussel, Belgium, 4MSD, Brussels, Belgium, 5CHU Saint-Pierre, Bruxelles, Belgium, 6University of Liege, Liege, Belgium, 7Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium, 8KU Leuven, Leuven, Belgium, 9Jessa Hospital, Hasselt, Belgium, 10MSD, Center for Observational and Real World Evidence (CORE), Zagreb, 01, Croatia, 11Merck & Co., Inc., Kenilworth, NJ, USA

Presentation Documents


To evaluate the economic impact of the pediatric immunization program (PIP) in Belgium from both healthcare payer and societal perspectives.


An economic model was developed focusing on the 6 vaccines included in Belgium’s PIP, recommended in children aged 0-10 years. Separate decision trees were used to model each disease (i.e., diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenzae B, hepatitis B, measles, mumps, rubella, pneumococcal, rotavirus, and meningococcal C). The 2018 birth cohort was followed over their lifetime, with the model projecting and comparing direct medical costs with and without immunization (based on current and pre–vaccine era disease incidence estimates, respectively). For the societal perspective, the model also included productivity loss costs associated with immunization and disease. The model estimated discounted incremental cases, disease-related deaths, life-years lost, quality-adjusted life-years lost, costs (2020 Euros), and an overall benefit-cost ratio (BCR). Scenarios considering hypothetical inclusion of varicella and meningococcal B immunizations were conducted.


Across all 12 diseases, the PIP prevented more than 220,000 cases of infections, 200 deaths, 7,000 life-years lost, and 7,000 quality-adjusted life-years lost. The PIP was associated with vaccination costs of over €90 million from the healthcare payer perspective and over €120 million from the societal perspective. Vaccination costs were fully offset by disease-related costs averted. Pediatric immunization was associated with over €30 million in averted direct medical costs (BCR = 1.4) and over €240 million averted societal costs (BCR = 3.0). Estimates of the societal value of the PIP were similar when hypothetical introductions of varicella (BCR = 2.9) or meningococcal B (BCR = 2.5) immunizations were considered.


The PIP brings large-scale prevention of disease-related morbidity, premature mortality, and associated costs, which has not been systematically assessed before in Belgium. This highlights the value of continued investment in the PIP.

Conference/Value in Health Info

2021-11, ISPOR Europe 2021, Copenhagen, Denmark

Value in Health, Volume 24, Issue 12, S2 (December 2021)




Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis


Multiple Diseases, Pediatrics, Vaccines

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