Economic analysis of pertussis illness in the Dutch population: implications for current and future vaccination strategies.

To reduce pertussis disease burden new vaccination strategies are considered in many countries. Since not only health benefits, but also economical aspects play a role when introducing new vaccinations, we estimated medical costs of pertussis in the Netherlands. Besides, we retrospectively performed a cost-utility analysis of the preschool booster introduced in 2001. Our results show that annual costs for pertussis are still considerable (approximately c.1.77 million for a population of 16 million). Although infants represented only 5% of cases, they accounted for 50% of the total costs. Hence, the economic burden of pertussis is largely determined by costs per infant case (c.1490) and only to a limited degree by costs per patient in other age-groups (circa c.75). Despite a substantial reduction in the number of cases, the preschool booster was not considered cost-effective. The effectiveness of universal adolescent or adult booster strategies -- to prevent pertussis in infants -- should also be considered from an economical point of view before being implemented.