TRIVAC decision-support model for evaluating the cost-effectiveness of Haemophilus influenzae type b, pneumococcal and rotavirus vaccination

Clark, Andrew; Jaúregui, Bárbara; Griffiths, Ulla K.; Janusz, Cara Bess; Bolaños-Sierra, Brenda; Hajjeh, Rana; Andrus, Jon Kim; Sanderson, Colin

doi:10.1016/j.vaccine.2013.05.045

Cited by 54 publications

(62 citation statements)

References 13 publications

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“…The pneumococcal component of TRIVAC (version 2.0) [16] was adapted for Peru to conduct the cost-effectiveness analysis (CEA) from the perspective of the Government of Peru, including direct costs borne by its public health system-MINSA and the EsSalud Social Security System [17].…”

Section: General Modeling Approach and Comparatorsmentioning

confidence: 99%

“…These outputs were then used to calculate health impact (e.g., DALYs averted), economic impact (e.g., net costs, incremental program costs and treatment costs averted), cost-effectiveness (e.g., cost-per-death averted) and cost-utility (e.g., cost-per-DALY averted). The results from each cohort were combined and used to report both the cumulative and annual health benefits and costs associated with each scenario [16].…”

Section: General Modeling Approach and Comparatorsmentioning

confidence: 99%

“…Deaths were estimated by applying the reported case-fatality ratio (CFR) to estimates of the number of cases post-vaccination. Pneumococcal meningitis sequelae were obtained by multiplying meningitis survivors (total estimated cases minus deaths) by the estimated proportion of those children that would develop neurological and auditory sequelae [16].…”

Section: General Modeling Approach and Comparatorsmentioning

confidence: 99%

“…The cost per case was derived from the proportion receiving care by provider type and the associated treatment cost per provider. To estimate the life-time costs associated with meningitis sequelae, an average estimated annual cost until death was assigned [16].…”

Section: General Modeling Approach and Comparatorsmentioning

confidence: 99%

“…However, two other estimates were assessed in the "what if" scenario analysis, one based on outpatient reports from the Peruvian ambulatory care health system, and the other, on data published by Teele and colleagues [28]. The TRIVAC model assumes that there are no AOM cases severe enough to lead to hospitalization or to be a cause of death [16].…”

Section: Acute Otitis Mediamentioning

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: General Modeling Approach and Comparatorsmentioning

confidence: 99%

Section: General Modeling Approach and Comparatorsmentioning

confidence: 99%

Section: General Modeling Approach and Comparatorsmentioning

confidence: 99%

Section: General Modeling Approach and Comparatorsmentioning

confidence: 99%

Section: Acute Otitis Mediamentioning

confidence: 99%

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