PBAC's latest decision on Adacel: Not recommended (2011). Considered for 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.
PBAC outcome
Not recommended
2011
ICER (AUD/QALY)
$75k/QALY
Range: $45k/QALY–$75k/QALY
Submissions
1
first 2011
Submissions
1
2011 → 2011
Eligible population
parents of newborn infants where there is no documented evidence of a dTpa booster having been given in the previous 10 years
Therapy area
Immunology
Evidence base
RCT, Single-arm, Registry
Key trials
Pichichero ME, Halperin SA et al, Blatter M et al, Ward JL et al, Le T et al, Van der Wielen A et al, Turnbull FM et al
Comparator
no routine vaccine
Economic model
Cost-minimisation
ICER note
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.
Why PBAC said no
Reasons cited in the latest PSD: 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