Economic evaluation of vaccination programme of 13-valent pneumococcal conjugate vaccine to the birth cohort in Japan

Abstract

Japan is now preparing to incorporate PCV-7 into the national childhood immunisation programme. Our recently published economic evaluation of using PCV-7 to the birth cohort suggests that the cost to gain one QALY is lower than the WHO's cost-effectiveness criterion for intervention. However, many countries have started to introduce PCV-13 into their national immunisation schedule replacing PCV-7 for preventing pneumococcal diseases among young children. These raise the need to appraise the 'value for money' of replacing PCV-7 with PCV-13 vaccination programme in Japan. We conducted a cost-effectiveness analysis with Markov model and calculated incremental cost effectiveness ratios (ICERs). Our base-case analyses, which assumed both PCVs have no net indirect effect and set the cost of PCV-7/PCV-13 per shot at ¥10,000 (US$125)/¥13,000 (US$163). The results show that in Base-case A (assumed PCV-13 has no additional protection against AOM compared to PCV-7), replacing PCV-7 with PCV-13 will cost ¥37,722,901 (US$471,536) or ¥35,584,455 (US$444,850) per QALY when the caregiver's productivity loss is not included or is included, respectively. While in Base-case B (assumed PCV-13 has additional protection against AOM compared to PCV-7), ¥343,830 (US$4298) per QALY or more QALY is gained by saving money without or with caregiver's productivity loss, respectively. We also find that, in Base-case B if cost per PCV-13 shot is equal to or less than that ¥17,000, then a PCV-13 vaccination programme offered to the birth cohort in Japan is likely to be a socially acceptable option compared to the current PCV-7 vaccination programme. Furthermore, if cost per PCV-13 shot is equal to or less than ¥12,000, replacing PCV-7 with PCV-13 will save money and gain more QALYs. While in Base-case A, the replacement can only be socially acceptable if cost per PCV-13 shot is equal to or less than ¥11,000.

Cost-Effectiveness Evaluation of the 10-Valent Pneumococcal Non-typeable Haemophilus influenzae Protein D Conjugate Vaccine and 13-Valent Pneumococcal Vaccine in Japanese Children

“…In our analysis, herd protection was not assumed given that the analytical time horizon was restricted to child age cohorts. To our knowledge, the implications of herd protection have not been addressed in any of the cost-effectiveness analyses published for Japan [ 51 , 52 ]. Previous studies have examined the potential magnitude of such indirect effects including herd protection and serotype replacement [ 38 ].…”

The economic burden of childhood invasive pneumococcal diseases and pneumonia in Taiwan: Implications for a pneumococcal vaccination program

“…The findings of this study extend the results of previous research on the economic burden of pneumococcal infection. Several cost-of-illness studies have been conducted in other countries; 13,[23][24][25] however, direct comparisons between these studies and the present study are difficult. The estimated burden of IPD (19.5 cases/100,000 individuals) and hospitalized pneumonia (17.4 cases/1,000 individuals) in this study is similar to reported rates in Hong Kong (23.7 cases/100,000 individuals and 931.6 cases/100,000 individuals, respectively) 26 and Japan (11.7 cases/ 100,000 individuals and 17.6 cases/1,000 individuals, respectively).…”

“…27 A comparison between the present study in Taiwan and studies in Japan may be feasible because of them have similar socioeconomic environments and approaches to healthcare delivery in these countries. 23,24 In this study, the estimated costs, including direct and indirect costs, were derived from data on the disease burden of pneumococcal infection with hospitalization according to detailed cost data. The annual direct costs associated with pneumococcal infection were estimated to be US $42.1 million for hospitals based on a birth cohort of 480,000 new born babies and assumed rates of 19.6 cases and 1,854.2 cases per 100,000 general pediatric hospitalizations related to IPD and pneumonia, respectively.…”

“…The annual direct costs associated with pneumococcal infection were estimated to be US $42.1 million for hospitals based on a birth cohort of 480,000 new born babies and assumed rates of 19.6 cases and 1,854.2 cases per 100,000 general pediatric hospitalizations related to IPD and pneumonia, respectively. 24 For a cohort with population of 220,000 new born babies, the equivalent admission costs were approximately US $15.1 million. Our hospital costs (US $9.9 million) were much lower than the estimates of admission costs in Japan.…”

Cost-effectiveness of a national immunization program with the 13-valent pneumococcal conjugate vaccine compared with the 10-valent pneumococcal conjugate vaccine in South Korea

“…Both IPD and pneumococcal pneumonia cases were assumed to carry an age-specific risk of mortality based on published case fatality rates. [32][33][34][35][36] No risk of mortality was considered for AOM cases.…”