Cost-effectiveness analysis of the 10-and 13-valent pneumococcal conjugate vaccines in Argentina


Uruena, A; Pippo, T; Betelu, MS; Virgilio, F; Giglio, N; Gentile, A; Jimenez, SG; Jauregui, B; Clark, AD; Diosque, M; Vizzotti, C; (2011) Cost-effectiveness analysis of the 10-and 13-valent pneumococcal conjugate vaccines in Argentina. Vaccine, 29 (31). pp. 4963-4972. ISSN 0264-410X DOI: 10.1016/j.vaccine.2011.04.111

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Abstract

Objective: Since the 10-valent pneumococcal conjugate vaccine (PCV-10) and 13-valent pneumococcal conjugate vaccine (PCV-13) were recently licensed for use in Argentina, both vaccines were evaluated to estimate the costs, health benefits and cost-effectiveness of adding a PCV to the routine child immunization schedule. Methodology: The integrated TRIVAC vaccine cost-effectiveness model from Pan American Health Organization's ProVac Initiative (Version 1.0.65) was used to assess the health outcomes of 20 successive cohorts from birth to 5 years of age. PCV-10 and PCV-13 were each compared to a scenario assuming no PCV vaccination. A 3 + 1 (three doses + booster) schedule and a vaccination price of US$ 20.75 per dose was assumed in the base case for both vaccines. Results: Introduction of PCV-13 rather than PCV-10 would increase the number of life years gained (LYG) by at least 10%. The number of LYG (and LYG after adjustment for DALY morbidity weights) was 56,882 (64,252) for PCV-10 compared to 65,038 (71,628) for PCV-13. From the health system perspective, the cost per DALY averted was US$ 8973 and US$ 10,948 for PCV-10 and PCV-13 respectively, and US$ 8546 and US$ 10,510 respectively, after incorporating costs saved by households. When PCV13 was compared to PCV10 directly, the additional benefits of PCV-13 was conferred at a cost of US$ 28,147 per DALY averted. Cost-effectiveness was influenced mainly by vaccine price, serotype replacement, pneumonia mortality and discount rate. Conclusion: Routine vaccination against S. pneumoniae in Argentina would be cost-effective with either PCV-10 or PCV-13. PCV-13, with higher coverage of local serotypes, would prevent more cases of pneumonia, invasive pneumococcal disease, sequelae and deaths with a higher number of LYG and DALYs averted, but PCV-10, due its higher impact in the prevention of AOM, would save more costs to the healthcare system. (C) 2011 Elsevier Ltd. All rights reserved.

Item Type: Article
Keywords: Pneumococcal conjugate vaccine, Cost effectiveness, Argentina, nontypable haemophilus-influenzae, protein-d, phid-cv, otitis-media, children, immunogenicity, vaccination, disease, prevention, pneumonia, wals p, 2008
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Research Centre: Vaccine Centre
PubMed ID: 21621575
Web of Science ID: 293043500013
URI: http://researchonline.lshtm.ac.uk/id/eprint/294

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