Economic evaluation of vaccination programme of 7-valent pneumococcal conjugate vaccine to the birth cohort in Japan

Abstract

Aiming to introduce 7-valent pneumococcal conjugate vaccine (PVC-7) into routine vaccination schedule, the government of Japan gives a temporary budget to encourage municipalities in launching public vaccination programme which started on November 26, 2010 and ends on March 31, 2012. This study aims to appraise the 'value for money' of PCV-7 vaccination programme from the societal perspective and the budget impact from the perspective of municipalities, which is responsible for providing routine vaccination. We conducted a cost-effectiveness analysis with Markov modelling and calculated incremental cost-effectiveness ratio (ICER) value of launching such programme with two levels of co-payment, ¥1000 (US$13) or ¥0, and two scenarios of the uptake of vaccine (vaccinated-alone or co-vaccinated with other vaccines). We found that when vaccinated-alone, ICERs in QALY were ¥7,441,000 (US$93,013) or ¥9,065,000 (US$113,313), and when co-vaccinated ¥7,441,000 (US$93,013) or ¥5,489,000 (US$68,613), without or with productivity loss, respectively, regardless of co-payment level of the programme. Co-vaccinated programmes had lower ICER than vaccinated-alone programmes due to the savings in productivity loss. By adopting WHO's classification that an intervention is 'cost-effective' if ICER (in QALY) is between 1 and 3 times of GDP as a criterion, PCV-7 vaccination programme in Japan is concluded as "cost-effective" from the perspective of society. The introduction of either no co-payment or ¥1000 (US$13) co-payment vaccination programme appears to be not budget saving for the first 6 years, whereas the level of budget impact are less than ¥11,000,000 (US$137,500) or ¥8,500,000 (US$106,250), respectively, for a municipality with 1000 birth cohort in the 1st year and 2nd to 5th year birth cohort proportional to the birth cohort population of estimated future population.

Estimating utility values for vesicoureteral reflux in the general public using an online tool

“…Our VUR utility results were similar to others for childhood conditions collected via standard interviews (e.g. otitis media 0.9950, bacteremia 0.9921), lending credence to the hypothesis that online TTO determination is a viable mode of utility elicitation [15]. …”

Cost-effectiveness of a pentavalent rotavirus vaccine in Japan

“…When evaluated from the societal perspective, it is projected that parental work loss associated with RGE episodes would also be substantially reduced by universal vaccination. The ICER values generated in this analysis are well within the range of other recently adopted childhood vaccines in Japan 70 . Exclusion of parental disutilities is likely to under-estimate the impact of rotavirus and decrease the estimated value of a vaccination program.…”

Economic evaluation of routine infant rotavirus immunisation program in Japan

“…In Japan, a study showed that PCV, an on the list of routine immunisation, was found to have <7,400,000 (US$69,811) per QALY gained. 27 If ICERs of rotavirus vaccination estimated in our study were to be compared with that of PCV's, ICERs of rotavirus immunisation program can still be considered as acceptable.…”