CPHA Canvax
Abstract

Background
Given that measles is eliminated in Canada and measles immunisation coverage in Ontario is high, it has been questioned whether Ontario’s measles outbreak response is worthwhile.

Aim
Our objective was to determine cost-effectiveness of measles containment protocols in Ontario from the healthcare payer perspective.

Methods
We developed a decision-analysis model comparing Ontario’s measles containment strategy (based on actual 2015 outbreak data) with a hypothetical ‘modified response’. The modified scenario assumed 10% response costs with reduced case and contact tracing and no outbreak-associated vaccinations; it was based on local and provincial administrative and laboratory data and parameters from peer-reviewed literature. Short- and long-term health outcomes, quality-adjusted life years (QALYs) and costs discounted at 1.5%, were estimated. We conducted one- and two-way sensitivity analyses.

Results
The 2015 outbreak in Ontario comprised 16 measles cases and an estimated 3,369 contacts. Predictive modelling suggested that the outbreak response prevented 16 outbreak-associated cases at a cost of CAD 1,213,491 (EUR 861,579). The incremental cost-effectiveness ratio was CAD 739,063 (EUR 524,735) per QALY gained for the outbreak response vs modified response. To meet the commonly accepted cost-effectiveness threshold of CAD 50,000 (EUR 35,500) per QALY gained, the outbreak response would have to prevent 94 measles cases. In sensitivity analyses, the findings were robust.

Conclusions
Ontario’s measles outbreak response exceeds generally accepted cost-effectiveness thresholds and may not be the most efficient use of public health resources from a healthcare payer perspective. These findings should be balanced against benefits of increased vaccine coverage and maintaining elimination status.

Rating See Comments Ratings

Category:

Policy,Immunization Policies,Cost Effectiveness,Vaccine Preventable Diseases,Communicable Diseases,Measles Policy
Immunization Policies
Cost Effectiveness
Vaccine Preventable Diseases
Communicable Diseases
Measles

0 Comments

Using the comment box below, provide your feedback for this resource. Tell the immunization community how you used the resource, what worked, what didn't and the changes you made. The feedback provided will help inform the immunization community and improve upon the resource made available on CANVax.

All comments are anonymous. Submitted comments will be reviewed for approval by the CANVax team to ensure it meets content submission guidelines. Please note that although CANVax aims to approve comments in a timely manner, volume may result in delays.