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Article: Correction to: Public Health Impact and Cost-Effectiveness Analysis of Routine Infant 4CMenB Vaccination in Germany to Prevent Serogroup B Invasive Meningococcal Disease.

Scholz, Stefan / Schwarz, Magdalena / Beck, Ekkehard / Meszaros, Kinga / Schneider, Melanie / Ultsch, Bernhard / Greiner, Wolfgang

Infectious diseases and therapy

2022 Volume 11, Issue 3, Page(s) 1311

Language	English
Publishing date	2022-04-13
Publishing country	New Zealand
Document type	Published Erratum
ZDB-ID	2701611-0
ISSN	2193-6382 ; 2193-8229
ISSN (online)	2193-6382
ISSN	2193-8229
DOI	10.1007/s40121-022-00618-8
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Article ; Online: Clinical impact and cost-effectiveness of the updated COVID-19 mRNA Autumn 2023 vaccines in Germany.

Joshi, Keya / Scholz, Stefan / Maschio, Michael / Kohli, Michele / Lee, Amy / Fust, Kelly / Ultsch, Bernhard / Van de Velde, Nicolas / Beck, Ekkehard

Journal of medical economics

2023 Volume 27, Issue 1, Page(s) 39–50

Abstract: Objectives: To assess the potential clinical impact and cost-effectiveness of coronavirus disease 2019 (COVID-19) mRNA vaccines updated for Autumn 2023 in adults aged ≥60 years and high-risk persons aged 30-59 years in Germany over a 1-year analytic ... ...

Abstract	Objectives: To assess the potential clinical impact and cost-effectiveness of coronavirus disease 2019 (COVID-19) mRNA vaccines updated for Autumn 2023 in adults aged ≥60 years and high-risk persons aged 30-59 years in Germany over a 1-year analytic time horizon (September 2023-August 2024). Methods: A compartmental Susceptible-Exposed-Infected-Recovered model was updated and adapted to the German market. Numbers of symptomatic infections, a number of COVID-19 related hospitalizations and deaths, costs, and quality-adjusted life-years (QALYs) gained were calculated using a decision tree model. The incremental cost-effectiveness ratio of an Autumn 2023 Moderna updated COVID-19 (mRNA-1273.815) vaccine was compared to no additional vaccination. Potential differences between the mRNA-1273.815 and the Autumn Pfizer-BioNTech updated COVID-19 (XBB.1.5 BNT162b2) vaccines, as well as societal return on investment for the mRNA-1273.815 vaccine relative to no vaccination, were also examined. Results: Compared to no autumn vaccination, the mRNA-1273.815 campaign is predicted to prevent approximately 1,697,900 symptomatic infections, 85,400 hospitalizations, and 4,100 deaths. Compared to an XBB.1.5 BNT162b2 campaign, the mRNA-1273.815 campaign is also predicted to prevent approximately 90,100 symptomatic infections, 3,500 hospitalizations, and 160 deaths. Across both analyses we found the mRNA-1273.815 campaign to be dominant. Conclusions: The mRNA-1273.815 vaccine can be considered cost-effective relative to the XBB.1.5 BNT162b2 vaccine and highly likely to provide more benefits and save costs compared to no vaccine in Germany, and to offer high societal return on investment.
MeSH term(s)	Adult ; Humans ; COVID-19 Vaccines ; BNT162 Vaccine ; 2019-nCoV Vaccine mRNA-1273 ; Cost-Benefit Analysis ; COVID-19/prevention & control ; Germany ; RNA, Messenger
Chemical Substances	COVID-19 Vaccines ; BNT162 Vaccine ; 2019-nCoV Vaccine mRNA-1273 (EPK39PL4R4) ; RNA, Messenger
Language	English
Publishing date	2023-12-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2270945-9
ISSN	1941-837X ; 1369-6998
ISSN (online)	1941-837X
ISSN	1369-6998
DOI	10.1080/13696998.2023.2290388
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Article: New Vaccine Platforms-Novel Dimensions of Economic and Societal Value and Their Measurement.

Buck, Philip O / Gomes, Dumingu Aparna / Beck, Ekkehard / Kirson, Noam / Mattera, Matthew / Carroll, Stuart / Ultsch, Bernhard / Jayasundara, Kavisha / Uhart, Mathieu / Garrison, Louis P

Vaccines

2024 Volume 12, Issue 3

Abstract: The COVID-19 pandemic's dramatic impact has been a vivid reminder that vaccines-especially in the context of infectious respiratory viruses-provide enormous societal value, well beyond the healthcare system perspective which anchors most Health ... ...

Abstract	The COVID-19 pandemic's dramatic impact has been a vivid reminder that vaccines-especially in the context of infectious respiratory viruses-provide enormous societal value, well beyond the healthcare system perspective which anchors most Health Technology Assessment (HTA) and National Immunization Technical Advisory Group (NITAG) evaluation frameworks. Furthermore, the development of modified ribonucleic acid-based (mRNA-based) and nanoparticle vaccine technologies has brought into focus several new value drivers previously absent from the discourse on vaccines as public health interventions such as increased vaccine adaptation capabilities, the improved ability to develop combination vaccines, and more efficient vaccine manufacturing and production processes. We review these novel value dimensions and discuss how they might be measured and incorporated within existing value frameworks using existing methods. To realize the full potential of next-generation vaccine platforms and ensure their widespread availability across populations and health systems, it is important that value frameworks utilized by HTAs and NITAGs properly reflect the full range of benefits for population health and well-being and cost efficiencies that these new vaccines platforms provide.
Language	English
Publishing date	2024-02-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines12030234
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Article: Public Health Impact and Cost-Effectiveness Analysis of Routine Infant 4CMenB Vaccination in Germany to Prevent Serogroup B Invasive Meningococcal Disease.

Scholz, Stefan / Schwarz, Magdalena / Beck, Ekkehard / Meszaros, Kinga / Schneider, Melanie / Ultsch, Bernhard / Greiner, Wolfgang

Infectious diseases and therapy

2021 Volume 11, Issue 1, Page(s) 367–387

Abstract: Introduction: Invasive meningococcal disease (IMD) is an uncommon, severe, life-threatening disease primarily affecting infants, with potential lifelong sequelae. Neisseria meningitidis (Nm) serogroup B (MenB) causes most IMD cases in Germany, many of ... ...

Abstract	Introduction: Invasive meningococcal disease (IMD) is an uncommon, severe, life-threatening disease primarily affecting infants, with potential lifelong sequelae. Neisseria meningitidis (Nm) serogroup B (MenB) causes most IMD cases in Germany, many of which can be prevented with four-component MenB (4CMenB) vaccination. The potential public health and economic impact of introducing routine 4CMenB infant vaccination in Germany was assessed. Methods: A dynamic transmission-based cost-effectiveness model adapted for Germany assessed the impact of infant 4CMenB universal mass vaccination (UMV) versus no vaccination. The model included the latest real-world evidence on vaccine effectiveness, the comprehensive burden of disease on patients (sequelae) and their family (quality of life impact), comprehensive German IMD costs, and vaccination uptake assumptions. Results: The largest public health impact was predicted in children: a rapid decline, 5 years after UMV implementation, of 39.9% (34.7%) for MenB (all IMD) cases aged 0-4 years and 42.4% (36.8%) in infants. Over lifetime (100-year time horizon), 4CMenB could prevent 3154 MenB (3303 all IMD) cases, 291 MenB (304 all IMD) deaths and 1370 MenB (1435 all IMD) long-term sequelae. 4CMenB saved 25,878 quality-adjusted life-years (QALYs), at a cost of €188,762 per QALY gained in the base case (societal perspective including lost productivity). Scenarios including potential Nm carriage protection (enabling herd protection) or societal preferences for the prevention of severe diseases led to more cost-effective results, while a scenario excluding IMD impact beyond the patient with increased discounting of vaccination health benefits produced less cost-effective results. Conclusions: MenB IMD is a vaccine-preventable disease. This analysis for Germany can inform decision-makers on the potential impact of introducing infant 4CMenB UMV. The program is predicted to rapidly produce health benefits (reduction in child cases, deaths and sequelae) at a cost per QALY to society of around €190,000 (base case), decreasing to around €78,000 when considering societal preferences and IMD underreporting.
Language	English
Publishing date	2021-12-07
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2701611-0
ISSN	2193-6382 ; 2193-8229
ISSN (online)	2193-6382
ISSN	2193-8229
DOI	10.1007/s40121-021-00573-w
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Book ; Online ; Thesis: Gesundheitsökonomische Analyse der Einführung einer Herpes zoster Impfung im deutschen GKV System

Ultsch, Bernhard Andreas

2014

Title variant	Health economic analysis of the implementation of a Herpes zoster vaccination in the German statutory health insurance (SHI) system
Author's details	Bernhard Andreas Ultsch
Language	German
Size	Online-Ressource
Publisher	Medizinische Fakultät Charité - Universitätsmedizin Berlin
Publishing place	Berlin
Document type	Book ; Online ; Thesis
Thesis / German Habilitation thesis	Berlin, Medizinische Fakultät Charité - Universitätsmedizin Berlin, Diss., 2014
Database	Former special subject collection: coastal and deep sea fishing

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Article: Use of Biologic Therapies in the Treatment of Asthma - A Comparative Real World Data Analysis on Healthcare Resource Utilization and Costs Before and After Therapy Initiation.

Hardtstock, Fraence / Krieger, Julia / Wilke, Thomas / Lukas, Marco / Ultsch, Bernhard / Welte, Robert / Quinzler, Renate / Maywald, Ulf / Timmermann, Hartmut

Journal of asthma and allergy

2022 Volume 15, Page(s) 407–418

Abstract: Background: Asthma is one of the most common chronic diseases in Germany. While many patients achieve asthma control under standard therapies, some patients still experience exacerbations and persistent airway obstructions. Thus, further pharmacological ...

Abstract	Background: Asthma is one of the most common chronic diseases in Germany. While many patients achieve asthma control under standard therapies, some patients still experience exacerbations and persistent airway obstructions. Thus, further pharmacological treatment is needed, and biologics could fill this gap, as they have shown clinical benefit in patients with severe asthma. Therefore, this real-world study aimed to compare healthcare resource utilization (HCRU) and associated costs before and after biologic therapy initiation. Methods: A retrospective claims data analysis has been conducted on adult asthma patients who initiated a long-term biologic therapy between January 2015 and June 2018. Patients were therapy-naïve to biologics for at least 12 months. HCRU and cost incurred by patients during 12 months before and after therapy initiation were compared. Results: Overall, 571 asthma patients initiated a biologic therapy during the observational period (316 omalizumab, 232 mepolizumab, 16 benralizumab, and 7 reslizumab). Patients had a mean age of 54.86 (62.70% female), and the majority (93.70%) received at least one follow-up prescription of their index-biologic agent within one year. During baseline, patients received on average 2.75 OCS prescriptions compared to 2.17 during follow-up. Most patients received less or the same amount of OCS after therapy initiation. Moreover, hospitalizations and asthma-related sick leave days decreased significantly. The average total costs per patient were €6618.90 during baseline and €22,832.33 during follow-up. Biologics mainly drove the increase; however, hospitalization costs were reduced significantly (€2443.37 vs €1941.93; p<0.001). Conclusion: Our study demonstrates an improved asthma control due to the initiation of a biologic therapy in terms of decreased hospitalization frequency, OCS consumption, and sick leave days. However, biologics are associated with high costs for healthcare providers during the first year after initiation. Therefore, short- and long-term clinical benefits and financial burden must be considered in the overall context of healthcare.
Language	English
Publishing date	2022-04-05
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2494877-9
ISSN	1178-6965
ISSN	1178-6965
DOI	10.2147/JAA.S354062
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Article ; Online: Epidemiology and treatment of patients with Chronic rhinosinusitis with nasal polyps in Germany-A claims data study.

Starry, Alexandra / Hardtstock, Fraence / Wilke, Thomas / Weihing, Julia / Ultsch, Bernhard / Wernitz, Martin / Renninger, Marius / Maywald, Ulf / Pfaar, Oliver

Allergy

2022 Volume 77, Issue 9, Page(s) 2725–2736

Abstract: Background: There are different levels of severity among patients who suffer from chronic rhinosinusitis with nasal polyps (CRSwNP). In this study, the epidemiology of CRSwNP and severe CRswNP was estimated.: Methods: A retrospective claim data ... ...

Abstract	Background: There are different levels of severity among patients who suffer from chronic rhinosinusitis with nasal polyps (CRSwNP). In this study, the epidemiology of CRSwNP and severe CRswNP was estimated. Methods: A retrospective claim data analysis was conducted on adult CRSwNP patients (ICD-10: J33), and those classified as severe CRSwNP patients with inadequate disease control (based upon combinations of previous and current treatments) between 2015 and 2019. Prevalence and incidence figures were calculated and extrapolated to the German population. In addition, baseline characteristics and treatment outcomes were analysed. Results: Overall, the 5-year prevalence of adult CRSwNP cases from 2015 to 2019 in Germany was 374,115 cases (about 5500 per million), with 12,989 (about 200 per million) patients being classified as severe CRSwNP with inadequate disease control, whereas 267,880 (about 3900 per million) patients were identified as having an incident CRSwNP diagnosis between 2016 and 2019. From the incident CRSwNP cohort, 80.55% had received at least one intranasal corticosteroid (INCS), 24.27% received at least 1 systemic corticosteroid (SCS), and 17.33% received at least one functional endoscopic sinus surgery (FESS) within 12 months after their incident diagnosis. Conclusion: Severe CRSwNP with inadequate disease control affects about 200 per million people in Germany. INCS is the first-choice treatment for most CRSwNP patients; however, for patients with severe CRSwNP, SCS are prescribed more frequently and long-term effects of these should be further investigated, especially if despite treatment, adequate disease control cannot be achieved.
MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Adult ; Chronic Disease ; Germany/epidemiology ; Humans ; Nasal Polyps/complications ; Nasal Polyps/epidemiology ; Nasal Polyps/therapy ; Retrospective Studies ; Rhinitis/diagnosis ; Rhinitis/epidemiology ; Rhinitis/therapy ; Sinusitis/surgery ; Sinusitis/therapy
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2022-04-08
Publishing country	Denmark
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	391933-x
ISSN	1398-9995 ; 0105-4538
ISSN (online)	1398-9995
ISSN	0105-4538
DOI	10.1111/all.15301
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Article ; Online: Epidemiology, treatment and health care resource use of patients with severe asthma in Germany - a retrospective claims data analysis.

Hardtstock, Fraence / Krieger, Julia / Wilke, Thomas / Lukas, Marco / Ultsch, Bernhard / Welte, Robert / Quinzler, Renate / Maywald, Ulf / Timmermann, Hartmut

The Journal of asthma : official journal of the Association for the Care of Asthma

2022 Volume 60, Issue 7, Page(s) 1280–1289

Abstract: Background: Asthma causes various clinical symptoms, including unpredictable severe exacerbations, and even though most patients can achieve a reasonable disease control due to adequate treatment, some patients do not. This study seeks to describe ... ...

Abstract	Background: Asthma causes various clinical symptoms, including unpredictable severe exacerbations, and even though most patients can achieve a reasonable disease control due to adequate treatment, some patients do not. This study seeks to describe healthcare resource utilization (HCRU) and treatment of asthma and severe asthma patients in Germany. Method: A retrospective claims data analysis has been conducted on adult asthma patients and a subset of patients with severe asthma, identified during July 2017 - June 2018. A proxy was used to identify severe asthma patients based on therapy options recommended within the German treatment guideline for treating these patients. These include (i) biologics, (ii) medium/high-dose inhaled corticosteroids (ICS) in conjunction with LABA/montelukast and antibiotics/oral corticosteroids (OCS), and (iii) long-term OCS therapy. HCRU and treatment of patients were observed during a 1-year follow-up period (July 2018 - June 2019). Results: The study included 388 932 adult asthma patients (prevalence: 7.90%), with 2.51%-12.88% affected by severe asthma (depending on the definition). 22.60% of all asthma patients experienced hospitalizations (severe asthma: 36.11%). Furthermore, 13.59% received OCS (severe asthma: 39.91%), but only 0.18% (severe asthma: 1.25%) received biologics. Only 23.95% (severe asthma: 41.17%) visited a pulmonologist. Conclusions: A considerable proportion of severe asthma patients receive long-term OCS therapy. However, less than 50% have seen a pulmonologist who would typically seek a change in treatment to avoid the long-term consequences of OCS. To optimize the treatment of severe asthma in Germany, better referral of these patients to specialists is needed and considering potential treatment alternatives.
MeSH term(s)	Adult ; Humans ; Asthma/drug therapy ; Asthma/epidemiology ; Retrospective Studies ; Drug Therapy, Combination ; Administration, Inhalation ; Adrenal Cortex Hormones/therapeutic use ; Patient Acceptance of Health Care ; Data Analysis ; Anti-Asthmatic Agents/therapeutic use
Chemical Substances	Adrenal Cortex Hormones ; Anti-Asthmatic Agents
Language	English
Publishing date	2022-12-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	603816-5
ISSN	1532-4303 ; 0277-0903
ISSN (online)	1532-4303
ISSN	0277-0903
DOI	10.1080/02770903.2022.2144350
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Article ; Online: Cost-Effectiveness of Routine Childhood Vaccination Against Seasonal Influenza in Germany.

Scholz, Stefan M / Weidemann, Felix / Damm, Oliver / Ultsch, Bernhard / Greiner, Wolfgang / Wichmann, Ole

Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

2020 Volume 24, Issue 1, Page(s) 32–40

Abstract: Objectives: In Germany, routine influenza vaccination with quadrivalent influenza vaccines (QIV) is recommended and reimbursed for individuals ≥60 years of age and individuals with underlying chronic conditions. The present study examines the cost- ... ...

Abstract	Objectives: In Germany, routine influenza vaccination with quadrivalent influenza vaccines (QIV) is recommended and reimbursed for individuals ≥60 years of age and individuals with underlying chronic conditions. The present study examines the cost-effectiveness of a possible extension of the recommendation to include strategies of childhood vaccination against seasonal influenza using QIV. Methods: A dynamic transmission model was used to examine the epidemiological impact of different childhood vaccination strategies. The outputs were used in a health economic decision tree to calculate the costs per quality-adjusted life year (QALY) gained from a societal and a third-party payer (TPP) perspective. Strain-specific epidemiology, vaccine uptake, and vaccine efficacy data from the 10 non-pandemic seasons from 2003/2004 to 2013/2014 were used, and cost data were drawn mainly from a health insurance claims data analysis and supplemented by estimates from literature. Uncertainty is explored via scenario, deterministic, and probabilistic sensitivity analyses. Results: Vaccinating 2- to 9-year-olds with QIV assuming a vaccine uptake of 40% is cost-saving with a benefit-cost ratio of 1.66 from a societal perspective and an incremental cost-effectiveness ratio of €998/QALY from a TPP perspective. Lower and higher vaccine uptakes show marginal effects, while extending the target group to 2- to 17-year-olds further increases the health benefits while still being below the willingness-to-pay (WTP) threshold. Assuming no vaccine-induced herd protection has a negative effect on the cost-effectiveness ratio, but childhood vaccination remains cost-effective. Conclusion: Routine childhood vaccination against seasonal influenza in Germany is most likely to be cost-saving from a societal perspective and highly cost-effective from a TPP perspective.
MeSH term(s)	Adolescent ; Adult ; Age Factors ; Aged ; Child ; Child, Preschool ; Cost of Illness ; Cost-Benefit Analysis ; Germany/epidemiology ; Health Expenditures ; Humans ; Immunization Programs/economics ; Infant ; Influenza Vaccines/administration & dosage ; Influenza Vaccines/economics ; Influenza Vaccines/immunology ; Influenza, Human/economics ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Middle Aged ; Models, Economic ; Quality-Adjusted Life Years ; Young Adult
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2020-11-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1471745-1
ISSN	1524-4733 ; 1098-3015
ISSN (online)	1524-4733
ISSN	1098-3015
DOI	10.1016/j.jval.2020.05.022
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Article ; Online: Clinical impact and cost-effectiveness of the updated COVID-19 mRNA Autumn 2023 vaccines in Germany

Joshi, Keya / Scholz, Stefan / Maschio, Michael / Kohli, Michele / Lee, Amy / Fust, Kelly / Ultsch, Bernhard / van de Velde, Nicolas / Beck, Ekkehard

medRxiv

Abstract	Objectives: To assess the potential clinical impact and cost-effectiveness of coronavirus disease 2019 (COVID-19) mRNA vaccines updated for Autumn 2023 in adults aged ≥60 years and high-risk persons aged 30-59 years in Germany over a 1-year analytic time horizon (September 2023--August 2024). Methods: A compartmental Susceptible-Exposed-Infected-Recovered model was updated and adapted to the German market. Numbers of symptomatic infections, number of COVID-19 related hospitalisations and deaths, costs, and quality-adjusted life-years (QALYs) gained were calculated using a decision tree model. The incremental cost-effectiveness ratio of an Autumn 2023 Moderna updated COVID-19 (mRNA-1273.815) vaccine was compared to no additional vaccination. Potential differences between the mRNA-1273.815 and the Autumn Pfizer-BioNTech updated COVID-19 (XBB.1.5 BNT162b2) vaccines, as well as societal return on investment for the mRNA-1273.815 vaccine relative to no vaccination, were also examined. Results: Compared to no Autumn vaccination, the mRNA-1273.815 campaign is predicted to prevent approximately 1,697,900 symptomatic infections, 85,400 hospitalisations, and 4,100 deaths. Compared to an XBB.1.5 BNT162b2 campaign, the mRNA-1273.815 campaign is also predicted to prevent approximately 90,100 symptomatic infections, 3,500 hospitalisations, and 160 deaths. Across both analyses we found the mRNA-1273.815 campaign to be dominant. Conclusions: The mRNA-1273.815 vaccine can be considered cost-effective relative to the XBB.1.5 BNT162b2 vaccine and highly likely to provide more benefits and save costs compared to no vaccine in Germany, and to offer high societal return on investment.
Keywords	covid19
Language	English
Publishing date	2023-10-10
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2023.10.09.23296505
Database	COVID19

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