OBJECTIVES:

Invasive meningococcal disease (IMD) is a major public health challenge associated with high case-fatality and life-long disabilities in survivors. Approximately 20% of survivors suffer at least one disability, including physical, neurological and psychological sequalae. Health state utility values (HSUVs) are needed to assess associated health outcomes in economic evaluations of new vaccines. This study aims to give a structured overview of HSUVs used in meningococcal vaccination cost-effectiveness models.

METHODS:

We systematically searched PubMed and EMBASE for economic evaluations of meningococcal vaccination published until January 15, 2022. The review focused on type, value, and source of reported HSUVs and is presented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

RESULTS:

A total of 29 publications were included. Eighteen models examined MenB vaccination strategies, 11 MenC/MenACWY vaccination. Utility data were reported for both, acute disease and sequalae, while reporting of the utilities used often showed weaknesses (e.g., unclear or inaccurate sources). HSUVs applied for the acute phase ranged from -0.51 to 0.860. Considered sequalae included physical (n=22/29), neurological (21/29), or psychological/behavioral sequalae (6/29). Utility data on sequalae were reported as utility decrements in 15 models and as HSUVs in 14 models, and varied greatly for some sequelae, such as renal failure (utility decrements: 0.58 to 0.82). Seven models considered utilities for caregiver spillovers, and four models applied a QALY adjustment factor.

CONCLUSIONS:

There are reporting gaps and weaknesses in the current evidence base for utilities used in economic models of meningococcal vaccination. Transparent evaluation and reporting of utility data are essential in economic evaluation. As caregiver spillover utilities and QALY adjustment factors enable consideration of the societal preference for interventions that prevent rare, but severe diseases, they should be evaluated in models and be discussed with decision-making bodies.