OBJECTIVES

Invasive Meningococcal Meningitis (IMM) imposes a substantial public health problem particularly in infants below one year expecting a significant risk of death and long-term disabilities. This study aimed at estimating clinical and economic benefits of providing an alternative meningococcal meningitis conjugate vaccine (MenACWY-DT) in high-risk infants in Egypt. A budget impact model was constructed to adopt the MenACWY-DT vaccine in the Egyptian national immunization program to high-risk infants.

METHODS

A decision tree model was developed to simulate the costs and health outcomes through 5-year time horizon from healthcare system perspective. The analysis was performed to compare between two scenarios; two doses MenACWY-DT vaccine at 9 and 12 months compared with no vaccination. The clinical data of annual IMM cases was collected by literature rapid review. Direct medical costs included the vaccination cost and IMM treatment cost was derived from semi-structured interviews through a Delphi Panel. The budget impact output was the difference in the total annual costs of the two scenarios, reported in Per Patient Per Month (PPPM). Uncertainty was handled through one-way sensitivity analysis.

RESULTS

Adopting the MenACWY-DT vaccine for high-risk infants would contribute to substantial savings estimated at EGP (4,205,675,197) over 5 years due to reduction in number of IMM cases. The vaccination resulted in budget savings EGP10,295 PPPM. The vaccine market share and the number of targeted patients are the most impactful parameters on the results.

CONCLUSIONS

The implementation of MenACWY-DT for high-risk infants in the Egyptian national immunization program has a substantial impact on public health. MenACWY-DT vaccine adoption will endure significant reduction in number of deaths due to IMM preventable complications and disabilities. Public health planning may consider an alternative strategy for high risk groups rather than meningitis polysaccharide vaccine at pre-school age.