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

Urueña, Analía; Pippo, Tomás; Betelu, María Sol; Virgilio, Federico; Giglio, Norberto; Gentile, Ángela; Jiménez, Salvador García; Jaúregui, Bárbara; Clark, Andrew; Diosque, Máximo; Vizzotti, Carla

doi:10.1016/j.vaccine.2011.04.111

Cited by 57 publications

(48 citation statements)

References 16 publications

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“…Also, a CEA in Colombia found that PCV13 prevents more disease and deaths with a higher LYG than PCV10, although PCV10 has more cost savings [42]. In Argentina, Urueña and colleagues, using the TRIVAC model, showed that PCV13 prevented more cases of pneumonia, IPD, sequelae with a higher number of LYG and averted more DALYs than PCV10 [40].…”

Section: Discussionmentioning

confidence: 99%

“…The strengths of our study are several. First, we used the TRIVAC model, which has been previously used in several countries in LAC: Argentina, Bolivia, Ecuador, El Salvador, Guatemala, Nicaragua and Paraguay [15,16,40] and validated by an external expert panel [16,67]. Second, the development of this study was transparent, with various independent, public and private institutions participating; all participants were required to declare any potential conflicts of interest and none were reported; data was registered and based on official communications by organizations.…”

Section: Discussionmentioning

confidence: 99%

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

Mezones‐Holguín

Canelo‐Aybar

Clark

et al. 2015

Vaccine

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Mezones‐Holguín

Canelo‐Aybar

Clark

et al. 2015

Vaccine

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“…This country has a comprehensive immunization program, in which MINSA provides vaccines to the whole population through the social security system and, in some cases, within the private sector [39,51]. There have been studies assessing cost effectiveness of PCV7 [23,27,28,52], but few studies assessing PCV10 and PCV13 [29,32,35] have been conducted in this part of the world.…”

Section: Discussionmentioning

confidence: 99%

“…In order to support the adoption of PCVs for vaccination schedules of immunization programs, cost-effectiveness studies have been performed in various countries [22][23][24][25][26][27][28][29]. However, in Latin America, few previous studies have evaluated the pharmacoeconomic and economic impact of PCV10 and PCV13 [26,[30][31][32][33][34][35]; none of these studies were conducted in Peru by a non-pharmaceutically funded institution.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children

Mezones‐Holguín

Bolaños-Díaz

Fiestas

et al. 2014

J Infect Dev Ctries

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Introduction: Pneumococcal pneumonia (PP) has a high burden of morbimortality in children. Use of pneumococcal conjugate vaccines (PCVs) is an effective preventive measure. After PCV 7-valent (PCV7) withdrawal, PCV 10-valent (PCV10) and PCV 13-valent (PCV13) are the alternatives in Peru. This study aimed to evaluate cost effectiveness of these vaccines in preventing PP in Peruvian children <5 yearsold. Methodology: A cost-effectiveness analysis was developed in three phases: a systematic evidence search for calculating effectiveness; a cost analysis for vaccine strategies and outcome management; and an economic model based on decision tree analysis, including deterministic and probabilistic sensitivity analysis using acceptability curves, tornado diagram, and Monte Carlo simulation. A hypothetic 100 vaccinated children/vaccine cohort was built. An incremental cost-effectiveness ratio (ICER) was calculated. Results: The isolation probability for all serotypes in each vaccine was estimated: 38% for PCV7, 41% PCV10, and 17% PCV13. Avoided hospitalization was found to be the best effectiveness model measure. Estimated costs for PCV7, PCV10, and PCV13 cohorts were USD13,761, 11,895, and 12,499, respectively. Costs per avoided hospitalization were USD718 for PCV7, USD333 for PCV10, andUSD 162 for PCV13. At ICER, PCV7 was dominated by the other PCVs. Eliminating PCV7, PCV13 was more cost effective than PCV10 (confirmed in sensitivity analysis). Conclusions: PCV10 and PCV13 are more cost effective than PCV7 in prevention of pneumonia in children <5 years-old in Peru. PCV13 prevents more hospitalizations and is more cost-effective than PCV10. These results should be considered when making decisions about the Peruvian National Inmunizations Schedule.

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“…For this reason, peer reviewed economic evaluations of PCVs worldwide and in Latin American countries (including Peru), have all included pneumonia, invasive disease and AOM [5][6][7][8] as the outcomes considered.…”

Section: Outcomes Consideredmentioning

confidence: 99%

Response to the cost effectiveness analysis of pneumococcal conjugated vaccines in Peru

Gómez¹,

Castrejón²,

Velde

2015

J Infect Dev Ctries

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

Cited by 57 publications

References 16 publications

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

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

Cost-effectiveness analysis of pneumococcal conjugate vaccines in preventing pneumonia in Peruvian children

Response to the cost effectiveness analysis of pneumococcal conjugated vaccines in Peru

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