Cost-effectiveness analysis of pneumococcal polysaccharide vaccination from age 60 in São Paulo State, Brazil

Neto, Joao Tonolio; Araújo, Gabriela Tannus Branco de; Gagliardi, Anna; Pinho, Amanda; Durand, Laure; Fonseca, Marcelo Cunio Machado

doi:10.4161/hv.7.10.15987

Cited by 16 publications

(31 citation statements)

References 53 publications

(72 reference statements)

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“…13,14,30 Indirect effects of the vaccination program (herd protection) was considered in 40% (8/ 20) of the reviewed studies: in 5 studies, which assessed HPV (2 studies), varicella, hepatitis A and dengue vaccination programs, 19,[26][27][28]32 the indirect effects were captured in the base case analysis by a dynamic model; and in 3 studies that assessed childhood pneumococcal conjugate vaccination using statistic decision tree model, the indirect protection was evaluated in a secondary or sensitivity analysis. [21][22][23] Six studies did not take indirect protection into account 14,17,18,24,25,29 and 6 did not inform. 13,15,16,20,30,31 Table 2 and Table 3 present the main methodological characteristics of the selected articles.…”

Section: Resultsmentioning

confidence: 99%

“…1), 20 were full HEEs that dealt with vaccines, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] all them published between 1995 and 2013. Figure 2 shows the growth in the number of HEEs on vaccines published in the period.…”

Section: Resultsmentioning

confidence: 99%

“…The most used types of HEE, according to the classification suggested by Drummond,8 were cost-effectiveness analysis (CEA, 45%), 17,[19][20][21][22]24,25,28,30 cost-utility analysis (CUA, 20%) 26,27,31,32 and both CEA and CUA performed simultaneously (15%). 18,23,29 Sixteen of the 20 articles (80%) were published in international journals; 5 in scientific journals specialized in vaccines, 4 in public health journals, 5 in infectious diseases journals.…”

Section: Resultsmentioning

confidence: 99%

“…15 Thirteen studies (65%) presented the incremental HEE: health economic evaluation cost-effectiveness ratio (ICER). [17][18][19][21][22][23][24][25][26][27][28][29]31 One study presented the net benefit, 14 and another presented cost difference. 13 Based on WHO proposed criteria for cost-effectiveness to interpret the studies' results, 11 considering the 13 studies that reported ICERs, the vaccination strategy was cost-saving in 3 studies; the ICER was <1 per capita gross domestic product (GDP) per DALY, considered as very cost-effective, in 7 studies; and the ICER was between 1 and 3 GDP/DALY, considered cost-effective, in 3 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies (30%) were funded by the pharmaceutical industry, 14,18,[21][22][23][24] 6 (30%) by the government and research funding agencies, 17,19,25,[28][29][30] and 3 (15%) were financed by research institutes. 15,31,32 Conflict of interest was reported in 35% (7/20) of the studies; 5 articles reported having conflict of interest.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of health economic evaluations of vaccines in Brazil

Sartori

Rozman

Decimoni

et al. 2017

Human Vaccines & Immunotherapeutics

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Methods: Systematic review of the literature. We searched multiple databases. Two researchers independently selected the studies and extracted the data. The methodological quality of individual studies was evaluated using CHEERS items. Results: Twenty studies were reviewed. The most evaluated vaccines were pneumococcal (25%) and HPV (15%). The most used types of HEE were cost-effectiveness analysis (45%) and cost-utility analysis (20%). The research question and compared strategies were stated in all 20 studies and the target population was clear in 95%. Nevertheless, many studies did not inform the perspective of analysis or data sources. Conclusions: HEE of vaccines in Brazil has increased since 2008. However, the studies still have methodological deficiencies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

A systematic review of health economic evaluations of vaccines in Brazil

Sartori

Rozman

Decimoni

et al. 2017

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

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Cost Effectiveness of Elderly Pneumococcal Vaccination in Presence of Higher-Valent Pneumococcal Conjugate Childhood Vaccination: Systematic Literature Review with Focus on Methods and Assumptions

2019

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Background Previous systematic reviews concluded that pneumococcal vaccination in the elderly was cost effective. However, recently published economic evaluations state that it may not be cost effective when children are vaccinated with higher-valent pneumococcal conjugate vaccines. The literature suggests that the outcomes of vaccination in the elderly are strongly influenced by the vaccine effectiveness (VE) against the vaccine-type pneumococcal diseases (PD) and the impact of childhood vaccination on the vaccine-type PD incidence in the elderly, but the extent remains unclear. Methods We conducted a systematic literature search of cost-effectiveness studies on vaccination in the elderly in the PubMed database starting from 2006. We included studies that consider the presence of a childhood vaccination with pneumococcal conjugate vaccine (PCV) 10 and PCV13. We focus on methods and assumptions used in modeling VE and epidemiology of PD over time. Results Twenty-eight economic evaluations underwent full-text review and data extraction. Thirteen were selected for quality assessment. The studies with a higher quality score provide evidence that vaccinating the elderly with PCV13 is not cost effective, when an ongoing rapid decline in the incidence of PCV13-type PD is modeled. A moderate persistence of PCV13 serotypes, in particular due to PCV10 childhood vaccination, makes vaccination of the elderly with PCV13 more attractive. There is no agreement that combining PCV13 with polysaccharide vaccine PPSV23 is cost effective. PPSV23 is attractive when it is effective against non-invasive PD. Conclusion Methodological approaches and assumptions in modeling VE and the indirect effects of childhood vaccination have a major impact on outcomes of decision-analytic models and cost-effectiveness estimates. Considering recently observed trends in the epidemiology of pneumococcal serotypes, there is currently inconclusive evidence regarding the cost effectiveness of pneumococcal vaccination of the elderly due to lack of studies that model key serotypes such as serotype 3 separately from other groups of serotypes.

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Clinical and microbiological implications of invasive pneumococcal disease in hospitalized patients (1998–2013)

Medeiros

Negrini

Silva

et al. 2016

The Brazilian Journal of Infectious Diseases

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The sample comprised 332 patients. Patient age ranged from less than one month to 89 years old (mean 20.3 years) and the sample was predominately male. Pneumonia (67.8%) was the most common disease, accounting for 18.2% of deaths. Serotypes 14, 1, 3, 9V, 6B, 6A, 23F, 19A, 18C, 19F, 12F, and 4 were the most common (75.3%). Most patients, or 67.5%, were cured without any complication (success), 6.9% had some type of sequela (failure), and 25.6% died (failure). In the case of deaths due to meningitis, strains of fully penicillin resistant pneumococcus were isolated. Furthermore, 68.2% of patients who died presented some type of comorbidity. The 60 and older age group presented the most significant association (Odds Ratio=4.2), with outcome failure regardless of the presence of comorbidity. Serotype 18C was the most significant risk factor both in raw analysis (Odds Ratio=3.8) and when adjusted for comorbidity (Odds Ratio=5.0) or age (Odds Ratio=5.4). The same occurred with serotype 12F (respectively, Odds Ratio=5.1, Odds Ratio=5.0, and Odds Ratio=4.7) CONCLUSION: The present findings highlight the importance of IPD among young adults and older adults. In the era of conjugate vaccines, monitoring serotypes in different age groups is essential to assess the impact and adequacy of immunization.

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Cost-effectiveness analysis of pneumococcal polysaccharide vaccination from age 60 in São Paulo State, Brazil

Cited by 16 publications

References 53 publications

A systematic review of health economic evaluations of vaccines in Brazil

A systematic review of health economic evaluations of vaccines in Brazil

Cost Effectiveness of Elderly Pneumococcal Vaccination in Presence of Higher-Valent Pneumococcal Conjugate Childhood Vaccination: Systematic Literature Review with Focus on Methods and Assumptions

Clinical and microbiological implications of invasive pneumococcal disease in hospitalized patients (1998–2013)

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