Cost-effectiveness analysis of a universal mass vaccination program with a PHiD-CV 2+1 schedule in Malaysia

Wang, Xiao Jun; Saha, Ashwini; Zhang, Xuhao

doi:10.1186/s12962-017-0079-2

Cited by 13 publications

(38 citation statements)

References 61 publications

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“…The results of our study supported the findings of earlier economic analyses, 10 suggesting higher public health and economic impacts with the adoption of PCV13 into the NIP over PCV10 in Malaysia. Contrary to our results, previous studies by Aljunid et al 9 and Wang et al 11 suggested more cost-savings with a PCV10 program as compared with PCV13. The differences in the predicted outcomes are driven by the differing assumptions used in the economic evaluations.…”

Section: Discussioncontrasting

confidence: 99%

“…The differences in the predicted outcomes are driven by the differing assumptions used in the economic evaluations. For instance, Wang et al 11 assumed cross-protection of PCV10 against non-vaccine serotypes such as serotypes 6A and 19A. Although there were some earlier case-control studies which demonstrated the possibility of cross-protection against 19A with PCV10, recent surveillance evidence demonstrates an increasing trend in cases due to 19A in both vaccinated and unvaccinated individuals in countries with a PCV10 program.…”

Section: Discussionmentioning

confidence: 99%

“…The findings consistently showed a cost-effectiveness ratio favoring the adoption of a national PCV program. [9][10][11][12] However, findings from the comparative analyses between PCV10 and PCV13 remain equivocal. The lack of agreement stems from a divergence in model assumptions as well as the modeling approach.…”

Section: Introductionmentioning

confidence: 99%

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Estimating the population health and economic impacts of introducing a pneumococcal conjugate vaccine in Malaysia- an economic evaluation

Shafie

Ahmad

Naidoo

et al. 2020

Human Vaccines & Immunotherapeutics

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Pneumococcal disease is a potentially fatal bacterial infection that is vaccine-preventable. Malaysia has yet to adopt a pneumococcal conjugate vaccine (PCV) into its national immunization program (NIP). In 2016, pneumonia was the 3 rd leading cause of death in children under five in Malaysia, accounting for 3.8% of underfive deaths. Introducing a pneumococcal conjugate vaccine (PCV) is an effective strategy to reduce the disease burden. This study used a decision-analytic model to assess the potential impacts of introducing the available PCVs (13-valent and 10-valent) in Malaysia. Epidemiological and costs inputs were sourced from published literature. For each vaccination program, health outcomes and associated healthcare costs were estimated. The scenarios of initiating PCV13 vs. PCV10 and the status quo (no pneumococcal vaccine) were compared. Serotype trends of Finland and the U.K. were used to model the clinical impacts of PCV10 and PCV13 respectively. The base-case analysis used a societal perspective over a 5-year time horizon. Compared with PCV10, PCV13 was projected to avert an additional 190,628 cases of pneumococcal disease and 1126 cases of death. The acquisition of PCV13 was estimated to cost an incremental US$89,904,777, offset by a cost reduction of-US$250,219,914 on pneumococcal disease-related medical care and lost productivity. PCV13 demonstrated a higher cost-saving potential over PCV10. Compared with no vaccination, PCV13 was estimated as cost-saving. Results were robust across a series of sensitivity analyses. The introduction of PCV13 in a NIP was estimated to reduce a significant burden of disease and to be a cost-saving for the Malaysian health system.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Estimating the population health and economic impacts of introducing a pneumococcal conjugate vaccine in Malaysia- an economic evaluation

Shafie

Ahmad

Naidoo

et al. 2020

Human Vaccines & Immunotherapeutics

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“…An investigational 11-valent vaccine in which all serotypes were conjugated to protein D, a highly conserved protein from NTHi, showed statistically significant efficacy against all AOM episodes due to NTHi [ 60 , 61 ]. Previous economic analyses have assumed an additional benefit for PCV10 in preventing NTHi AOM based on evidence for this investigational 11-valent vaccine [ 47 , 50 , 51 , 62 , 63 ]. However, real-world effectiveness data published over the last few years have presented mixed evidence.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Economic Impact of a Potential Switch from 13-Valent to 10-Valent Pneumococcal Conjugate Infant Vaccination in Canada

et al. 2018

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IntroductionPneumococcal conjugate vaccines (PCVs) have been available in Canada since 2001, with 13-valent PCV (PCV13) added to the infant routine immunization program throughout all Canadian provinces by 2011. The use of PCVs has dramatically reduced the burden of pneumococcal disease in Canada. As a result, decision-makers may consider switching from a more costly, higher-valent vaccine to a lower-cost, lower-valent vaccine in an attempt to allocate funds for other vaccine programs. We assessed the health and economic impact of switching the infant vaccination program from PCV13 to 10-valent PCV (PCV10) in the context of the Canadian health care system.MethodsWe performed a review of Canadian databases supplemented with published and unpublished data to obtain the historical incidence of pneumococcal disease and direct and indirect medical costs. Observed invasive pneumococcal disease (IPD) trends from surveillance data were used as a basis to forecast the future number of cases of IPD, pneumococcal pneumonia, and acute otitis media given a PCV13- or PCV10-based program. Costs and outcomes over 10 years were then estimated and presented in 2017 Canadian dollars discounted at 3% per year.ResultsSwitching from PCV13 to PCV10 would result in an additional 762,531 cases of pneumococcal disease over 10 years. Although PCV13 has a higher acquisition cost, switching to PCV10 would increase overall costs by over $500 million. Forecasted overall disease incidence was estimated substantially higher with PCV10 than with PCV13 primarily because of the potential reemergence of serotypes 3 and 19A. PCV13 was also cost saving compared with PCV10, even within a 5-year time horizon. Probabilistic sensitivity analysis showed that a PCV13-based program remained cost saving in all simulations.ConclusionAlthough switching to a PCV10-based infant vaccination program in Canada might result in lower acquisition costs, it would also result in higher public health cost and burden because of serotype reemergence.FundingPfizer Inc.Electronic supplementary materialThe online version of this article (10.1007/s40121-018-0206-1) contains supplementary material, which is available to authorized users.

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“…A published Markov cohort model was adapted to simulate the epidemiological burden of pneumococcal and NTHi-related diseases, including IPDs, pneumonia and AOM, within a registered live birth cohort in Taiwan [15,16]. The cohort-based analyses are commonly used for health economic modelling for determining the direct impact of medical interventions [16], and the current model has been used by previous cost effectiveness studies in other countries [17][18][19]. Figure 1 shows the Markov cohort model for the analyses.…”

Section: Markov Modelmentioning

confidence: 99%

Cost-effectiveness evaluation of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine for children in Taiwan

Chung

Huang

et al. 2020

Cost Eff Resour Alloc

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Background: Streptococcus pneumoniae (S. pneumoniae) and non-typeable Haemophilus influenzae (NTHi) are substantial contributors to morbidity and mortality of diseases including invasive pneumococcal diseases (IPDs), pneumonia and acute otitis media (AOM) worldwide. In Taiwan, 10-valent pneumococcal polysaccharide and NTHi protein D conjugate vaccine (PHiD-CV) and 13-valent pneumococcal conjugate vaccine (PCV13) are licensed in children against pneumococcal disease. In addition to S. pneumoniae, clinical trials suggest efficacy of PHiD-CV against NTHi AOM. This study aims at evaluating the cost-effectiveness of a 2 + 1 schedule of PHiD-CV vs. PCV13 2 + 1 in the universal mass vaccination program of infants in Taiwan. Methods: A published Markov cohort model was adapted to simulate the epidemiological burden of IPD, pneumonia and AOM for a birth cohort in Taiwan over 10 years. The probability of entering a specific health state was based on the incidence rate of the diseases. Only direct medical costs were included, and costs and outcomes were discounted annually. Vaccine efficacy assumptions were based on published data and validated by a panel of independent experts. Clinical, epidemiological, and serotype distribution data were based on locally published data or the National Health Insurance Research Database. Price parity of vaccines was assumed. Published pneumococcal disease-related disutility weights were used due to lack of local data. Incremental cost-effectiveness ratio was calculated and benchmarked against the recommended threshold in Taiwan. Extensive one-way sensitivity analysis, alternative scenarios and probabilistic sensitivity analysis were performed to test the robustness of the results. Results: PHiD-CV would potentially reduce the number of NTHi-related AOM cases substantially and prevent comparable IPD and pneumonia-related cases and deaths compared to PCV13. Over a 10-year horizon, PHiD-CV is estimated to dominate PCV13, saving 6.7 million New Taiwan Dollars (NTD) and saving 21 quality-adjusted life years. The result was robust over a wide range of sensitivity analyses. The dominance of PHiD-CV was demonstrated in 90.5% of the simulations. Conclusions: PHiD-CV 2 + 1 would provide comparable prevention of IPD, pneumonia cases and additional reduction of NTHi-AOM cases, and is considered dominant compared with PCV13 2 + 1 in Taiwan.

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Cost-effectiveness analysis of a universal mass vaccination program with a PHiD-CV 2+1 schedule in Malaysia

Cited by 13 publications

References 61 publications

Estimating the population health and economic impacts of introducing a pneumococcal conjugate vaccine in Malaysia- an economic evaluation

Estimating the population health and economic impacts of introducing a pneumococcal conjugate vaccine in Malaysia- an economic evaluation

Clinical and Economic Impact of a Potential Switch from 13-Valent to 10-Valent Pneumococcal Conjugate Infant Vaccination in Canada

Cost-effectiveness evaluation of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine for children in Taiwan

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