Cost-effectiveness analysis of pneumococcal vaccination for infants in China

Objective: The aims of this study were to estimate the cost-effectiveness of the Haemophilus influenzae type b (Hib) vaccine for the prevention of childhood pneumonia, meningitis and other vaccinepreventable diseases in mainland China from a societal perspective and to provide information about the addition of the Hib vaccine to Chinese immunization programs. Methods: A decision tree and the Markov model were used to estimate the costs and effectiveness of the Hib vaccine versus no Hib vaccine for a birth cohort of 100,000 children in 2016. The disease burden was estimated from the literature, statistical yearbooks and field surveys. Vaccine costs were calculated from government reports and the United Nations International Children's Emergency Fund (UNICEF) website. The WHO cost-effectiveness thresholds were used to evaluate the Hib vaccine intervention. A one-way sensitivity analysis and probabilistic sensitivity analysis were performed to evaluate the parameter uncertainties. Results: Within the hypothetical cohort, under a vaccination coverage of 90%, the Hib vaccine could reduce 91.4% of Hib pneumonia and 88.3% of Hib meningitis; the Hib vaccine could also prevent 25 deaths, 24 meningitis sequelae cases and 9 hearing loss cases caused by Hib infection. From a societal perspective, the incremental cost-effectiveness ratio (ICER) of the Hib vaccine compared with no vaccination was US$ 13,640.1 at the market price, which was less than 3 times the GDP per capita of China in 2016. The ICER of the Hib vaccine was US$ ¡59,122.9 at the UNICEF price, indicating a cost savings. The largest portion of the uncertainty in the result was caused by the annual incidence of all-cause pneumonia, proportion of pneumonia caused by Hi, vaccine costs per dose, annual incidence of Hib meningitis and costs per episode of meningitis. The models were robust considering parameter uncertainties. Conclusion: The Hib vaccine is a cost-effective intervention among children in mainland China. The cost of Hib vaccine should be reduced, and it should be introduced into Chinese immunization programs.

Section: Discussionmentioning

confidence: 99%

“…QALYs for health states were derived from published studies. [44][45][46][47] Cost-effectiveness analysis ICERs were used to compare the 2 alternative strategies. The Chinese Government has not determined an official policy for using cost-effectiveness evidence for health care decision-making.…”

Section: Effectiveness Parametersmentioning

confidence: 99%

Cost-effectiveness of the Haemophilus influenzae type b vaccine for infants in mainland China

Ning

Yin

et al. 2017

“…8 Due to the lack of a disease surveillance system for pneumonia, meningitis and otitis media in China, the true disease burden and proportion of diseases prevented by vaccines are unknown. In many previous cost-effectiveness analyses of pneumococcal vaccination for Chinese infants, [9][10][11] all causes of pneumonia were incorporated into models, due to a lack data on the proportion of pneumonia cases caused by pneumococcus. Due to the lack of clear data on this issue, the introduction of the PCV, Hib and influenza vaccines into the Chinese immunization program has been delayed.…”

Section: Introductionmentioning

confidence: 99%

The etiology of community-acquired pneumonia among children under 5 years of age in mainland China, 2001–2015: A systematic review

Ning

Wang

et al. 2017

This article provides the most comprehensive analysis to date of the factors contributing to CAP in children under 5 y of age. S. pneumoniae, H. influenzae and influenza were the most common vaccine-preventable diseases in children. Corresponding, vaccines should be introduced into Chinese immunization programs, and further economic evaluations should be conducted. RSV is common in Chinese children and preventative measures could have a substantial impact on public health. These data also have major implications for diagnostic strategies and empirical treatments.

“…33 One recent report published by Maurer KA and colleagues has reported that adding PCV-7, PCV-10, and PCV-13 through the Chinese Expanded Program on Immunization are cost-effective from a societal perspective. 34 In that analysis, the vaccination cost of PCV-7, PCV-10, and PCV-13 per infant was only $148, which is the price of one dose of the vaccines. However, the pneumococcal vaccination schedule consisted of 4 doses per infant to yield the high immunogenicity.…”

Section: Discussionmentioning

confidence: 96%

Cost-effectiveness analysis of routine 13-valent pneumococcal conjugate vaccinations in Chinese infants

Zhou

et al. 2018