PharmacoEconomics & Outcomes News 792, p17 - 2 Dec 2017
Maternal streptococcal B vaccine
cost effective in sub-Sahara
Streptococcal B (GBS) vaccination in pregnant women
appears to be cost effective for the prevention of
neonatal sepsis and meningitis in low-income countries
in sub-Saharan Africa, according to findings of a study
published in Vaccine.
A decision tree and Markov model populated with
data from published literature was used to evaluate the
cost effectiveness of maternal GBS immunisation for the
prevention of early-onset and late-onset GBS cases and
deaths in infants in Ghana, Guinea-Basseau, Nigeria and
Uganda, compared with no GBS immunisation.
Cost effectiveness was assessed based on two
benchmarks: 0.5 GDP
and GDP per capita per
disability-adjusted life-year (DALY) averted. The
assumed cost of the vaccine was $7
per dose, and the
assumed vaccine efficacy rate against serotypes was
70%. It was assumed that vaccine coverage was
equivalent to the proportion of pregnant women who
underwent four or more antenatal visits (ANC4).
Maternal GBS vaccination was estimated to prevent
34% of GBS cases and deaths in Uganda and
Nigeria (ANC4 48% and 51%, respectively), 42-43% of
cases and deaths in Guinea-Bissau (ANC4 65%), and
57% of cases and deaths in Ghana (ANC4 87%).
The estimated cost of GSB vaccination was
$350 per DALY averted in Guinea-Bissau, Ghana
and Nigeria, which was below 50% of GDP per capita in
these countries. The estimated cost of per DALY averted
was higher in Uganda ($573).
Sensitivity analyses found that the primary drivers of
cost effectiveness were the cost per dose, and the
incidences of GBS cases and GBS deaths.
"The vaccine would be most cost-effective in
countries like Nigeria, Guinea Bissau, and Ghana, where
the case fatality ratio is high, and less cost-effective in
countries like Uganda, where it is relatively low, but its
cost/DALY is within the range for newer vaccines already
included in the routine childhood vaccination schedules
of all these, and other, low-income countries," said the
* gross domestic product
** 2014 US dollars
Russell LB, et al. Cost-effectiveness of maternal GBS immunization in low-income
sub-Saharan Africa. Vaccine : 9 Nov 2017. Available from: URL: http://
PharmacoEconomics & Outcomes News 2 Dec 2017 No. 7921173-5503/17/0792-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved