Cost-effectiveness and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru

The clinical and economic burden associated with invasive and non-invasive pneumococcal and non-typeable Haemophilus influenzae (NTHi) diseases is substantial in the Latin America and Caribbean region, where pneumococcal vaccines have only been introduced to a few countries. This study analyzed the...

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Bibliographic Details
Published in:BMC public health 2013-10, Vol.13 (1), p.1025-1025, Article 1025
Main Authors: Gomez, Jorge Alberto, Tirado, Juan Carlos, Navarro Rojas, Aldo Amador, Castrejon Alba, Maria Mercedes, Topachevskyi, Oleksandr
Format: Article
Language:English
Subjects:
Bacterial pneumonia
Child
Child, Preschool
Children
Conjugate vaccines
Cost of Illness
Cost Savings
Cost-Benefit Analysis
Economic aspects
Epidemiology
Haemophilus influenzae
Health aspects
Humans
Infant
Markov Chains
Medical care
Medical economics
Medical research
Medicine, Experimental
Models, Statistical
Peru - epidemiology
Pneumococcal Infections - economics
Pneumococcal Infections - epidemiology
Pneumococcal Infections - prevention & control
Pneumococcal Vaccines - economics
Pneumonia
Quality-Adjusted Life Years
Streptococcus pneumoniae
Utilization
Vaccination
Vaccines, Conjugate - economics
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Summary:The clinical and economic burden associated with invasive and non-invasive pneumococcal and non-typeable Haemophilus influenzae (NTHi) diseases is substantial in the Latin America and Caribbean region, where pneumococcal vaccines have only been introduced to a few countries. This study analyzed the cost-effectiveness and cost utility of three different pneumococcal conjugate vaccines (PCVs) for Peru. A Markov model that simulated the disease processes in a birth cohort over a lifetime, within 1,128 month cycles was used to evaluate the cost-effectiveness of 10-valent pneumococcal NTHi protein D conjugate vaccine (PHiD-CV) and 7- and 13-valent PCVs (PCV-7 and PCV-13). Expected quality-adjusted life years (QALYs), cost-savings and incremental cost-effectiveness ratios (ICERs) were calculated. Without vaccination, pneumonia was associated with the greatest health economic burden (90% of QALYs lost and 63% of lifetime direct medical costs); while acute otitis media (AOM) was responsible for 1% of QALYs lost and 25% of direct medical costs. All vaccines were predicted to be cost-effective for Peru, with PHiD-CV being most cost-effective. PHiD-CV was predicted to generate 50 more QALYs gained and required a reduced investment (-US$ 3.4 million) versus PCV-13 (discounted data), and was therefore dominant and cost saving. The probabilistic sensitivity analysis showed that PHiD-CV generated more QALYs gained at a reduced cost than PCV-13 in 84% of the simulations and less QALYs gains at a reduced cost in 16%. Additional scenarios using different assumptions on vaccine efficacies based on previous evidence were explored, but no significant change in the overall cost-effective results were observed. The results of this modeling study predict that PCVs are likely to be a cost-effective strategy to help relieve the epidemiological and economic burden associated with pediatric pneumococcal and NTHi diseases for Peru. PHiD-CV is likely to be a dominant (better health gains at a reduced net cost) intervention compared to PCV-13 or PCV-7. The most significant drivers for these results are the better health and economic profile of PHiD-CV against AOM and its reduced cost per dose available through the PAHO Revolving Fund in the LAC region.
ISSN:1471-2458
1471-2458
DOI:10.1186/1471-2458-13-1025