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A vaccine for
Lyme disease was approved in 1998 for use in the US. Given the high cost of the vaccine, the low risk of
Lyme disease in many areas, and the largely curable nature of the
disease, the cost-effectiveness of the vaccine in various risk groups is uncertain. This study was undertaken to examine the cost-effectiveness of the
Lyme disease vaccine and the factors that influence its cost-effectiveness.
We constructed a Markov decision-analysis model to evaluate the clinical effectiveness and cost-effectiveness of the
Lyme disease vaccine in populations at various levels of risk for the
disease. The probabilities of clinical events and costs were estimated from reports in the literature. Sensitivity analyses assessed the impact of potential variations of parameters on model results.
At the average national incidence of
Lyme disease (0.0067%), the incremental cost-effectiveness of vaccination was approximately $1,600,000 per case averted when a yearly booster was given for 10 years after the standard initial vaccination regimen of 3 inoculations at 0, 1, and 12 months. For populations with an annual
Lyme disease incidence of 1% (the incidence in several well-defined geographical areas of the US), the incremental cost-effectiveness was approximately $9,900 per case averted.
Disease incidence had to exceed 10% before vaccination with yearly boosters became both more effective and more cost saving than no vaccination.
Lyme disease vaccine is cost-effective only for individuals who live in areas where
Lyme disease is endemic and who are frequently exposed to ticks.