The economic disease burden of measles in Japan and a benefit cost analysis of vaccination, a retrospective study.

Tuesday, 29th of October 2013

[source]BMC Health Services Research[|source]

Between 1999 and 2003, Japan experienced a series of measles epidemics. During this period, there were an estimated 100,000 to 200,000 cases.  As in many other measles outbreaks, insufficient disease suppression due to low vaccination coverage,  was the major driver for the outbreaks. Characteristiccally, epidemis in Japan were all small-medium in epidemic size, and the main victims were unvaccinated 1-year-old children. The National Institute of Infectious Diseases, Japan (NIID) reflected on these characteristics in a publication entitled, Action Plans to Control Measles and the Future Problems and proposed that infants be vaccinated as soon as possible after their firrst birthday to reduce the age group s susceptibility to measles infection. 

 

In this report, the authors  estimated the nationwide economic disease burden of measles based on the clinical data of local measles epidemics in Matsudo City, Chiba Prefecture, Japan between 1999 and 2001. At the same time, authors attempted to evaluate the economic effectiveness of the proposal that infants be immunized soon after their first birthday by benefit cost ratio (BCR). The report concludes with an estimated total measles treatment cost found to be US$ 404 million with a BCR of 2.48 in the base case before recommending immunization of children soon after their first birthday to be suitable and effective. More details are available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3217873/

Abstract

BACKGROUND: During 1999-2003, Japan experienced a series of measles epidemics, and in Action Plans to Control Measles and the Future Problems, it was proposed that infants be immunized soon after their one-year birthday.In this study, we attempted to estimate the nationwide economic disease burden of measles based on clinical data and the economic effectiveness of this proposal using the benefit cost ratio.

METHODS: Our survey target was measles patients treated at Chiba-Nishi general  hospital from January 1999 to September 2001. Two hundred ninety-one cases were extracted from the database. The survey team composed of 3 pediatricians and 1 physician from Chiba-Nishi general hospital examined patient files and obtained additional information by telephone interview.We analyzed data based on a static model, which assumed that the number of measles patients would be zero after 100% coverage of single-antigen measles vaccine.Costs were defined as the direct cost for measlestreatment, vaccination and transportation and the indirect cost of workdays lost due to the nursing of patients, hospital visits for vaccination or nursing due to adverse reactions. Benefits were defined as savings on direct and indirect costs. Based on these definitions, we estimated the nationwide costs of treatment and vaccination.

RESULTS: Using our static model, the nationwide total cost for measles treatment was estimated to be US$ 404 million, while the vaccination cost was US$165 million. The benefit cost ratio of the base case was 2.48 and ranged from 2.21 to 4.97 with sensitivity analysis.

CONCLUSIONS: Although the model has some limitations, we conclude that the policy of immunizing infants soon after their one-year birthday is economically effective.