Future GBS vaccine highly likely to be cost-effective

New research has found that once a GBS meningitis vaccine is developed and licenced, it is highly likely that it will be found cost-effective, even if it costs the NHS as high as £54 a dose.

The study, which has been funded by Meningitis Research Foundation (MRF) and published today [4 Oct 2018] in the journal Vaccine, could mean that a GBS vaccine is more quickly introduced into the UK immunisation programme once a vaccine is licenced for use.

GBS disease, caused by Group B Streptococcus bacteria, is responsible for half of all meningitis cases in very young babies, and is a leading cause of sepsis - otherwise known as septicaemia or blood poisoning.

One in five pregnant women carry the GBS bacteria. To most it is harmless but it can cause death or serious complications in their babies.

Currently there is no vaccine available to protect people against GBS and cases are becoming more common. This is despite the UK’s current GBS prevention strategy which involves identifying at-risk expectant mothers and giving them antibiotics during childbirth.

A vaccine for pregnant women would protect them and their unborn baby against the deadly disease. Several GBS vaccines for pregnant women are in development.

Dr Kyriaki Giorgakoudi, Lecturer in Health Economics at Brunel University London, said: “Group B Streptococcus is part of the body’s natural flora, and most of us who have it don’t experience any adverse effects. But for young babies, GBS can be dangerous.

“GBS disease affects 1 in 1000 babies in the UK, which is nearly 750 babies every year, with more than 1 in 20 of these cases being fatal. Nearly half the survivors of GBS meningitis will have adverse long-term outcomes, with GBS causing lasting damage to their brain functions.”

Dr Giorgakoudi and her colleagues - from the Universities of Cambridge and Birmingham, St George’s, University of London, and Public Health England - designed a mathematical model and plugged in everything currently known about GBS disease in the UK, factoring in extensive data about health outcomes and economic costs.

The researchers used their model to explore different scenarios and identify when maternal immunisation - expected to be used together with the current antibiotic strategy - would represent value for money.

Taking a conservative view of the benefits of a GBS vaccine, and following the government’s vaccine advisors’ (the JCVI) guidelines on cost-effectiveness studies, the model shows the vaccine for maternal immunisation remains cost-effective at £54 per vaccine dose.

“Cost-effectiveness in healthcare is about understanding the best we can do with the currently available financial resources, and how we can allocate these resources to get the most health benefits,” Dr Giorgakoudi said.

“Our study estimates that introducing a GBS vaccine would prevent 369 cases of GBS in infants annually. Twenty-one infant deaths will be averted and 103 maternal disease cases will also be avoided.”

Reducing neonatal meningitis is an international priority for MRF.

Linda Glennie, Director of Research at MRF said “Screening pregnant women for GBS is not routine in many countries, and while guidance exists to identify at-risk expectant mothers, it is not consistently delivered and cannot prevent all cases.

“GBS is still rising in the UK and beyond. Preventing GBS by offering vaccinations for pregnant women would be the best way to save lives. We are delighted that the findings from this research could help speed up introduction of a vaccine once it is licenced to protect pregnant women and their newborn babies from GBS.”

A cost-effectiveness evaluation like this had not been undertaken in advance of the meningococcal B (MenB) vaccine being licenced for use. Consequently, there was a delay in getting the MenB vaccine introduced into the UK immunisation schedule after licensure. That’s why this research is important, because it will enable a GBS vaccine to be more quickly introduced once licenced.

Read Anne Marie Harris’ story about her daughter Amber Rose who contracted GBS.