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

Abstract

a b s t r a c tObjective: To evaluate the cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine (PCV10) versus the 13-valent PCV (PCV13) to the National Immunization Schedule in Peru for prevention of pneumococcal disease (PD) in children <5 years of age. Methods: The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (version 2.0) was applied from the perspective of the Government of Peru. Twenty successive cohorts of children from birth to 5 years were evaluated. Clinical outcomes were pneumococcal pneumonia (PP), pneumococcal meningitis (PM), pneumococcal sepsis (PS) and acute otitis media from any causes (AOM). Measures included prevention of cases, neurological sequelae (NS), auditory sequelae (AS), deaths and disability adjusted life years (DALYs). A sensitivity analyses was also performed. Findings: For the 20 cohorts, net costs with PCV10 and PCV13 were US$ 363.26 million and US$ 408.26 million, respectively. PCV10 prevented 570,273 AOM; 79,937 PP; 2217 PM; 3049 PS; 282 NS; 173 AS; and 7512 deaths. PCV13 prevented 419,815 AOM; 112,331 PN; 3116 PM; 4285 PS; 404 NS; 248 AS;and 10,386 deaths. Avoided DALYs were 226,370 with PCV10 and 313,119 with PCV13. Saved treatment costs were US$ 37.39 million with PCV10 and US$ 47.22 million with PCV13. Costs per DALY averted were US$ 1605 for PCV10, and US$ 1304 for PCV13. Sensitivity analyses showed similar results. PCV13 has an extended dominance over PCV10. Conclusion: Both pneumococcal vaccines are cost effective in the Peruvian context. Although the net cost of vaccination with PCV10 is lower, PCV13 prevented more deaths, pneumococcal complications and sequelae. Costs per each prevented DALY were lower with PCV13. Thus, PCV13 would be the preferred policy; PCV10 would also be reasonable (and cost-saving relative to the status quo) if for some reason 13-valent were not feasible.

Cost-effectiveness of introducing the pneumococcal conjugate vaccine for children under 5 years in the Islamic Republic of Iran

“…The TRIVAC model requires the following data: demographic data, disease burden, local vaccine serotype distribution, vaccine efficacy, health service utilization, vaccination programme costs and health service costs (6). Based on the data entered, the model calculates the number of cases, deaths and sequelae of S. pneumoniae infection, as well as the associated costs in scenarios with and without vaccination.…”

“…meningitis and bacteraemia) that can be life-threatening (2)(3)(4)(5). Invasive pneumococcal diseases kill over 500 000 children under 5 years old each year (6), and accounted for nearly 9% of deaths in children aged 1-59 months in 2008 in South America (7). Children in low-income and developing countries are particularly at risk of severe disease caused by S. pneumoniae (6).…”

“…Invasive pneumococcal diseases kill over 500 000 children under 5 years old each year (6), and accounted for nearly 9% of deaths in children aged 1-59 months in 2008 in South America (7). Children in low-income and developing countries are particularly at risk of severe disease caused by S. pneumoniae (6). The cost of diseases caused by S. pneumoniae is reported to be one of the highest in terms of the use of health care resources (6,8).…”

“…Children in low-income and developing countries are particularly at risk of severe disease caused by S. pneumoniae (6). The cost of diseases caused by S. pneumoniae is reported to be one of the highest in terms of the use of health care resources (6,8). However, invasive pneumococcal diseases can be prevented by vaccination (3,6).…”

“…Among all serotypes of S. pneumoniae, only a few are invasive and the new pneumococcal conjugate vaccines (PCVs) protect against them (6,9). Of the most preventable serotypes, the PCV vaccines target either 10 serotypes (PCV-10) or 13 serotypes (PCV-13) (9).…”