INTRODUCTION: Despite its low incidence in France, invasive serogroup B 
meningococcal disease remains a public health concern. A new vaccine against the 
disease, Bexsero(®), has been licensed in the EU. We studied the epidemiological 
impact and cost-effectiveness of routine vaccination using Bexsero(®) in order 
to inform the decision-making process regarding its potential inclusion in the 
vaccination schedule.
METHODS: A multi-generational Markov model was used. Time horizon was set to 100 
years. Five vaccination strategies were evaluated: infants at 3, 5, 6 and 13 
months, toddlers at 13, 15 and 27 months and adolescents at 15 years provided 2 
doses one month apart. A booster dose at 15 years old and a catch-up for 15 
years old subjects during the first 15 years of the programme were added to the 
infant and toddler strategies. Costs per QALY gained were computed from a 
restricted societal perspective including direct costs only. Herd immunity was 
simulated in an alternative base-case scenario and sensitivity analyses.
RESULTS: In the base-case analysis without herd immunity and with all cohorts 
vaccinated, at € 40 per vaccine dose, routine infant vaccination would provide 
the lowest cost per QALY gained (€ 380,973) despite only preventing 18% of 
cases. Under the assumption of herd immunity, the adolescent vaccination would 
provide the lowest cost per QALY gained (€ 135,902) preventing 24% of cases. 
Infant vaccination with a late booster and catch-up would prevent 51% of cases 
with a cost of € 188,511 per QALY gained.
CONCLUSIONS: Given current meningococcal epidemiology in France and the 
available data on the protection provided by Bexsero(®), our modelling work 
showed that routine vaccination against serogroup B meningococcal disease is not 
cost-effective.