An Economic Analysis of Mumps Vaccination in Fiji: Static Model Simulation of Routine Measles-Mumps-Rubella (MMR) Vaccination Instead of Current Measles-Rubella (MR) Vaccination

Abstract

Mumps remains endemic in Fiji, with 7802 cases reported between 2016 and 2018. The introduction of mumps vaccination has been discouraged due to perceptions of mumps as a self-limited disease and the perceived high cost of mumps vaccines. We estimated the benefits and costs of introducing a mumps vaccination program in Fiji. First, we estimated the burden of mumps and mumps-related complications in Fiji based on the reported cases in the Fiji National Notifiable Disease Surveillance System between 2016 and 2018. We then developed a static simulation model with stable mumps herd immunity after routine measles-mumps-rubella (MMR) vaccination. Finally, we compared the estimated economic burden of mumps with current MR vaccination and the assumptive burden of the stable-state simulation model after routine MMR vaccination. The benefit-cost ratios (BCRs) were 2.65 from the taxpayer view and 3.00 from the societal view. A probabilistic sensitivity analysis indicated that the 1st and 99th percentiles of BCRs were 1.4 and 5.2 from the taxpayer's perspective and 1.5 and 6.1 from the societal perspective. From both the taxpayer and societal perspectives, the probability of BCRs greater than 1.0 was 100%. A routine MMR program has value for money from both the taxpayer and societal perspectives. MMR vaccination should be urgently introduced in Fiji.

Keywords: Fiji; cost benefit analysis; mumps vaccination; static model.

Figure 1

Flowchart of mumps infection and adverse events due to vaccination.

Figure 2

Number of reported mumps case in Fiji NNDSS between Jan. 2016 and Dec. 2018.

Figure 3

One-way analysis results (tornado plot of the benefit–cost ratio): (a) taxpayer’s perspective; (b) societal perspective.

Figure 4

Cumulative distribution function(CDF) of benefit–cost ratios (BCRs) from the societal perspective and taxpayer’s perspective with 100,000 iterations of random sampling of five parameters.