Adacel
Not recommended Immunology
To reduce transmission of pertussis from parents to newborn infants who are too young to have been fully vaccinated against this disease under the infant NIP schedule.
1
Submissions
2011–11
On the record
$45k–75k
ICER range
1 sourced ICER · 2011
ICER stated
Cost basis
Cost-effectiveness
Multiple ICER estimates presented: static model for mothers only $45,000–$75,000 per QALY; TDM (with herd immunity) <$15,000 per LYG; multivariate sensitivity analysis $45,000–$75,000 per LYG. PBAC noted both incremental costs and effects from TDM are highly uncertain.
Decision context
Populationparents of newborn infants where there is no documented evidence of a dTpa booster having been given in the previous 10 years
Why it was knocked back
- uncertain clinical effectiveness of the cocooning strategy (no RCT evidence for transmission reduction from parent to infant), potential for subclinical infection in adults to transmit pertussis to infants, highly uncertain cost-effectiveness with sensitivity analyses showing ICER likely to increase substantially if herd immunity excluded or incidence adjusted to realistic levels
Submission history
| Decided | Outcome | Comparator | ICER | Evidence |
|---|---|---|---|---|
| Nov 2011 | Not recommended | no routine vaccine | $45k–75k | RCT, Single-arm, Registry |
Similar precedents
Pertussis Vaccine Acellular With Diphtheria And Tetanus Toxoids, Adsorbed78%Diphtheria And Tetanus Toxoids Combined With Pertussis Vaccine-Acellular77%Pertussis Vaccine-Acellular, Combined With Diphtheria And Tetanus Toxoids (Dtap)73%Rotavirus Vaccine69%Diphtheria + Tetanus + Acellular Pertussis Vaccine67%Diphtheria, Tetanus, Acellular Pertussis Vaccine (Dtpa)67%Meningococcal Group B Vaccine (Recombinant, Adsorbed)66%Diphtheria, Tetanus, Pertussis, Hepatitis B, Poliomyelitis And Haemophilus Influenzae Type B Conjugate Vaccine63%