Background Latvia experiences high nationwide incidence rates of tick-born encephalitis (TBE) infection and is one of the highly endemic European countries. Despite the availability of preventive vaccination against the TBE, the infection rate has increased during the last decade. TBE disease is associated with permanent neurological damage requiring specialized healthcare over the lifetime of those affected. In Latvia state-funded vaccination is provided only to children living in endemic areas and to orphans. The aim of this paper is to determine cost-effectiveness of preventive vaccination in Latvian adults. Methods We developed a decision analytic model to assess the cost-effectiveness of a preventive TBE vaccination in Latvian adults. Patients were divided in two equal cohorts of vaccinated and unvaccinated individuals aged ≥18 years. A mixed model structure was employed to calculate direct treatment costs and outcomes in the symptomatic disease phase and to estimate long-term costs and health outcomes. Total estimated treatment costs in euros and outcomes as Quality-adjusted Life Years (QALYs) over a lifetime horizon were compared between cohorts and the base-case analysis result presented as the incremental cost-effectiveness ratio (ICER) from the healthcare provider's perspective. Results The base-case analysis shows that preventive vaccination against TBE infection is dominant when compared to a no vaccination strategy in the Latvian adult population. The findings of sensitivity analysis suggest that changes in selected parameters do not significantly affect the result. Conclusions Given the recommended vaccination schedule, preventive vaccination against TBE infection in Latvian adults is dominant from the healthcare provider's perspective.
Hlevickis et al. (Fri,) studied this question.