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Cost-effectiveness of a web-based decision aid for parents deciding about MMR vaccination


  • Sandy Tubeuf

    () (Leeds Institute of Health Sciences, University of Leeds)

  • Richard Edlin

    (School of Population Health, University of Auckland)

  • Swati Shourie

    (Monash Injury Research Institute, Monash University)

  • Francine Cheater

    (School of Nursing Sciences, University of East Anglia)

  • Hilary Bekker

    (Leeds Institute of Health Sciences, University of Leeds)

  • Cath Jackson

    (York Trials Unit, University of York)


Background: Levels of measles in England and Wales are at their highest for 18 years and strategies targeting the different groups of parents who don’t vaccinate their children continue to be needed. Decision aids for childhood immunisation decisions appear to be effective in achieving vaccine uptake, however their cost effectiveness is unknown. Aim: To assess the cost-effectiveness of a web-based decision aid to increase MMR vaccine uptake. Design and Setting: Economic evaluation conducted alongside a cluster randomised controlled trial. 50 GP practices in the North of England were randomised to one of three trial arms (decision aid, leaflet, nothing) alongside usual practice. 220 first-time parents (child aged 3 to 12 months) were recruited. Methods: Parents self-reported their contacts with the NHS and other previous/expected resource utilisation; associated costs were calculated. Vaccine uptake was collected from GP practices. Cost-effectiveness is expressed in terms of incremental cost per first vaccine uptake. Multiple imputations were used to account for missing data and findings were adjusted for baseline differences in parents’ levels of decisional conflict for the MMR decision. Results: MMR uptake was highest for those receiving the decision aid (42/42, 100% vs. usual practice 61/62, 98% and leaflet arm 69/75, 92%) and was associated with lower cost. The decision aid has a high chance of being cost-effective regardless of the value placed on obtaining additional vaccinations. Conclusions: The decision aid appears to offer an efficient means of decision support for parents.

Suggested Citation

  • Sandy Tubeuf & Richard Edlin & Swati Shourie & Francine Cheater & Hilary Bekker & Cath Jackson, 2014. "Cost-effectiveness of a web-based decision aid for parents deciding about MMR vaccination," Working Papers 1401, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
  • Handle: RePEc:lee:wpaper:1401

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    File Function: First version, 2014
    Download Restriction: Final version published in British Journal of General Practice August 2014 64:e493-e499; doi:10.3399/bjgp14X680977

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    References listed on IDEAS

    1. Andrew Briggs & Taane Clark & Jane Wolstenholme & Philip Clarke, 2003. "Missing.... presumed at random: cost-analysis of incomplete data," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 377-392.
    2. Patrick Royston, 2005. "Multiple imputation of missing values: Update of ice," Stata Journal, StataCorp LP, vol. 5(4), pages 527-536, December.
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    cost-effectiveness; decision aid; vaccination; immunisation; MMR;

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