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Volume 5, Number 3—June 1999

Perspective

The Cost Effectiveness of Vaccinating against Lyme Disease

Martin I. MeltzerComments to Author , David T. Dennis, and Kathleen A. Orloski
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Table 3

Sensitivity analyses: Cost or savings per case averted (5th, 95th percentiles) by altering assumed vaccine effectiveness and the cost of treating Lyme disease sequelaea

Base treatment costsb x 0.5
Base treatment costsc Base treatment costsb x 1.5
Probability of Lyme disease Vaccine effectivenessd
Vaccine effectivenessd
0.75 0.95 0.85 0.75 0.95
0.005 23,018 17,404 16,231 15,720 10,105
(23,527; 22,556) (17,947; 16,927) (17,283; 15,261) (17,249;14,286) (11,641;8,703)
0.01 9,684 6,877 4,467 2,386 Net savingse
(10,178; 9197) (7,372; 6,412) (5,531; 3,487) (3,846; 958) (1,220; savee)
0.03 795 Net savingse Net savingse Net savingse Net savingse
(1,303; 330) (385; savee) (save; savee) (save; savee) (save; savee)

aThese results were generated by setting the probability of detecting and successfully treating early Lyme disease at 0.80 and the cost of vaccination at $100 per year.
bBase treatment costs are given in Table 2. The data presented in this table were generated by multiplying the costs in Table 2 by either 0.5 (i.e., reducing costs by half) or by 1.5 (i.e. increasing costs by half).
cFor comparison, the results using the base costs (Table 2) are presented here, assuming a vaccine effectiveness of 0.85. Figure 2 presents the complete set of results using the base costs.
dThe initial assumed level of vaccine effectiveness was 0.85 (Figure 2).
eNet savings are generated when a person is vaccinated against Lyme disease and the costs saved by not having to treat a case of Lyme disease are higher than the costs of vaccination plus the costs of having to treat a case of Lyme disease that occurs after vaccination. The net savings range from $140 (probability of Lyme disease = 0.03, vaccine effectiveness = 0.95, cost of treating Lyme disease sequelae = 0.5 x base costs) to $7,438 (probability of Lyme disease = 0.03, vaccine effectiveness = 0.95, cost of treating Lyme disease sequelae =1.5 x base costs). Note also that in some instances where mean net savings are calculated, the 5th percentiles are net costs.

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