The Lifetime Return on Investment of Measles, Mumps, and Rubella Vaccination in Belgium and Poland

OBJECTIVES: Measles, mumps, and rubella (MMR) vaccination programs have resulted in dramatic reductions in disease burden and the elimination of measles and rubella in some countries. However, there is limited information regarding the economic benefits resulting from these programs. We estimated the economic value, as measured by return on investment (ROI), of MMR vaccination programs using real-world data from Belgium and Poland.

METHODS: Previously published models estimating overall ROI for childhood immunization programs in Belgium and Poland were adapted by extracting country-specific data on MMR-related costs and disease epidemiology. The models followed a single birth cohort throughout their lifetime (i.e., a 100-year time-horizon). Disease incidence data in pre- and post-vaccination-program eras were used to estimate costs from the payer perspective (direct costs) and societal perspective (direct and indirect costs) under “no vaccination” and “vaccination” scenarios. Vaccine acquisition costs were assumed to be equal to the list prices for MMR-II® (Merck, Sharp & Dohme LLC, Rahway, NJ, USA) in Belgium and Poland. All costs (in 2020 Euros) were discounted consistent with country-specific guidance (Belgium: 3%; Poland: 5%).

RESULTS: Under the payer perspective, lifetime vaccination and averted treatment costs were €8,038,702 and €60,754,676 in Belgium, respectively, and €3,320,130 and €21,872,618 in Poland; equivalently, the ROI was 6.56 (= €60,754,676/€8,038,702 – 1) for Belgium and 5.59 (= €21,872,618/€3,320,130 – 1) for Poland. Under the societal perspective, the ROI was 12.17 for Belgium and 17.17 for Poland. For both perspectives, the robustness of the ROI was assessed by examining potential increases in the vaccine acquisition cost. When vaccine acquisition costs were doubled, the ROI remained favorable: the ROI was 3.74 for Belgium and 2.35 for Poland under the payer perspective (9.12 and 8.23 under the societal perspective).

CONCLUSIONS: MMR vaccination programs have substantially averted disease-related costs and provided significant ROI from both the payer and societal perspectives.