Diphtheria + Tetanus + Acellular Pertussis Vaccine

7.1 The PBAC recommended including an 18-month booster dose of the DTPa vaccine on the NIP for the prevention of pertussis on the basis of cost-effectiveness compared with the current schedule without the booster.PSD · Nov 2014

7.2 The PBAC recalled that the NIP previously included a booster dose of DTPa at approximately 18 months until 2003, when it was removed with the introduction of the booster dose for adolescents (15-17 years). The PBAC considered the removal of the 18-month dose may have contributed to resurgence in pertussis notifications between 2008 and 2012.PSD · Nov 2014

6.18 The economic evaluation is a cost-utility analysis. The submission presented the model in two parts. The first was a compartmental transmission model using Matlab, and the second was a static decision tree model using Excel. The former describes the evolution of the disease, while the latter calculates the effects of the infection on individuals and the health care system.PSD · Nov 2014

Summary of model structure and rationale Component Summary Time horizon 100 years in the model Outcomes QALYs A dynamic transmission model to estimate the discounted number of symptomatic cases over Methods used to 100 year of pertussis and the percentage of these cases who would be notified.PSD · Nov 2014

6.15 The submission described the 18-month DTPa booster as superior in terms of comparative effectiveness and inferior in terms of comparative safety over the status quo of care.PSD · Nov 2014

6.16 The PBAC considered that the claim of superior comparative effectiveness was reasonable, though agreed with the ESC that the extent of the comparative effectiveness was unclear.PSD · Nov 2014