In1 Economic and Clinical Burden of Pneumococcal Diseases and Acute Otitis Media in Taiwan: A Nationwide Population-Based Database Analysis

Chang, CJ; Wang, Po‐Chang; Huang, Yu‐Chi; Wu, BS

doi:10.1016/s1098-3015(11)73066-2

Cited by 4 publications

(7 citation statements)

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“…The latter may account for the high incidence rate of AOM in Korea compared with other countries in the region, e.g., Taiwan. 41 …”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of infant pneumococcal vaccination with PHiD-CV in Korea

Zhang¹,

Leeuwenkamp²,

et al. 2017

Human Vaccines & Immunotherapeutics

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Background: Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) can cause invasive pneumococcal diseases (IPD), pneumonia, and acute otitis media (AOM). Both the 10-valent pneumococcal NTHi protein D conjugate vaccine (PHiD-CV) and the 13-valent pneumococcal conjugate vaccine (PCV-13) are included in the National Immunization Program for infants in Korea. This study aimed to evaluate the cost-effectiveness of the 3+1 schedule of PHiD-CV versus that of PCV-13 for National Immunization Program in Korea.Methods: A published Markov model was adapted to evaluate the cost-effectiveness of vaccinating the 2012 birth cohort with PHiD-CV vs. PCV-13 from the Korean government perspective over 10 y. Best available published data were used for epidemiology, vaccine efficacy and disutilities. Data on incidence and direct medical costs were taken from the national insurance claims database. Sensitivity analyses were conducted to explore the robustness of the results.Results: PHiD-CV was projected to prevent an additional 195,262 cases of pneumococcal diseases and NTHi-related diseases vs. PCV-13, with a substantially greater reduction in NTHi-related AOM and a comparable reduction in IPD and community-acquired pneumonia. Parity-priced PHiD-CV generated a health gain of about 844 quality-adjusted life years and a total cost-saving of approximately 4 million United States Dollars (USD) over 10 y. 93% of probabilistic simulations found PHiD-CV 3+1 to be the dominant vaccine option.Conclusion: Compared to PCV-13, PHiD-CV was projected to provide similar prevention against IPD and community-acquired pneumonia but would prevent more cases of AOM. Parity-priced PHiD-CV was anticipated to generate substantial cost-savings and health benefits vs. PCV-13 in Korea.

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“…The latter may account for the high incidence rate of AOM in Korea compared with other countries in the region, e.g., Taiwan. 41 …”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of infant pneumococcal vaccination with PHiD-CV in Korea

Zhang¹,

Leeuwenkamp²,

et al. 2017

Human Vaccines & Immunotherapeutics

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“…Age-specific incidence data for hospitalized pneumococcal meningitis and bacteremia (Additional file 1 : Table S1) and hospitalized all-cause pneumonia (Additional file 1 : Table S2) were sourced from a study that estimated disease burden from the hospital records of six tertiary hospitals across Malaysia during 2006–2007 [ 25 ]. Malaysian case fatality ratios (CFRs) were not available, so we referred to the CFRs from a retrospective population-based National Health Insurance Reimbursement Database study from Taiwan [ 26 ] (Additional file 1 : Tables S1 and S2). This approach was conservative, considering Taiwan has a more advanced healthcare system and better healthcare access than Malaysia.…”

Section: Methodsmentioning

confidence: 99%

“…GP consultation rates for all-cause pneumonia (Additional file 1 : Table S2) were also lacking in Malaysia, but hospitalized pneumonia incidence rates were available. Therefore, an estimate was calculated, based on Malaysian hospitalization rates [ 25 ] and the ratio of Taiwanese GP consultation to hospitalization rates [ 26 ], considering similar healthcare access level within a country. Due to a lack of local/regional data on the long-term sequelae of IPD, these were not included.…”

Section: Methodsmentioning

confidence: 99%

“…Age-specific AOM GP consultation rates (Additional file 1 : Table S3) were based on published data from the Philippines [ 27 ] due to the lack of Malaysian data. Myringotomy rates (Additional file 1 : Table S3) were adapted from data from the Philippines [ 27 ] that were based on insurance data from Taiwan [ 26 ] and consultation with local ear, nose and throat experts. In the base case, all cases of AOM were assumed to result in a GP consultation.…”

Section: Methodsmentioning

confidence: 99%

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

Wang

Saha²,

Zhang

2017

Cost Eff Resour Alloc

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BackgroundCurrently, two pediatric pneumococcal conjugate vaccines are available in the private market of Malaysia—13-valent pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide and non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV). This study aimed to evaluate the cost-effectiveness of a universal mass vaccination program with a PHiD-CV 2+1 schedule versus no vaccination or with a PCV13 2+1 schedule in Malaysia.MethodsA published Markov cohort model was adapted to evaluate the epidemiological and economic consequences of programs with no vaccination, a PHiD-CV 2+1 schedule or a PCV13 2+1 schedule over a 10-year time horizon. Disease cases, deaths, direct medical costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) were estimated. Locally published epidemiology and cost data were used whenever possible. Vaccine effectiveness and disutility data were based on the best available published data. All data inputs and assumptions were validated by local clinical and health economics experts. Analyses were conducted from the perspective of the Malaysian government for a birth cohort of 508,774. Costs and QALYs were discounted at 3% per annum. One-way and probabilistic sensitivity analyses were performed.ResultsCompared with no vaccination, a PHiD-CV 2+1 program was projected to prevent 1109 invasive pneumococcal disease (IPD), 24,679 pneumonia and 72,940 acute otitis media (AOM) cases and 103 IPD/pneumonia deaths over 10 years, with additional costs and QALYs of United States dollars (USD) 30.9 million and 1084 QALYs, respectively, at an ICER of USD 28,497/QALY. Compared with a PCV13 2+1 program, PHiD-CV 2+1 was projected to result in similar reductions in IPD cases (40 cases more) but significantly fewer AOM cases (30,001 cases less), with cost savings and additional QALYs gained of USD 5.2 million and 116 QALYs, respectively, demonstrating dominance over PCV13. Results were robust to variations in one-way and probabilistic sensitivity analyses.ConclusionsA PHiD-CV 2+1 universal mass vaccination program could substantially reduce pneumococcal disease burden versus no vaccination, and was expected to be cost-effective in Malaysia. A PHiD-CV 2+1 program was also expected to be a dominant choice over a PCV13 2+1 program in Malaysia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12962-017-0079-2) contains supplementary material, which is available to authorized users.

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“…Taiwan has observed serotype replacement in IPD, notably the increased prevalence of serotype 19A, with the proportion of serotype 19A for all ages increasing from 5.5 to 25.3% from 2008 to 2012 [3,4]. In Taiwan, AOM has caused significant health and economic burden for children < 5 years, with greater than 200,000 cases per year [8]. S. pneumoniae and NTHi infections were identified as the top two bacterial pathogens that cause AOM worldwide.…”

Section: Introductionmentioning

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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In1 Economic and Clinical Burden of Pneumococcal Diseases and Acute Otitis Media in Taiwan: A Nationwide Population-Based Database Analysis

Cited by 4 publications

References 0 publications

Cost-effectiveness analysis of infant pneumococcal vaccination with PHiD-CV in Korea

Cost-effectiveness analysis of infant pneumococcal vaccination with PHiD-CV in Korea

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

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

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