Evaluación Económica de un Programa de Inmunización Infantil en México Basado en la Vacuna Neumocócica Conjugada 13-Valente

Muciño-Ortega, Emilio; Mould-Quevedo, J; Farkouh, Raymond; Strutton, David

doi:10.1016/j.jval.2011.05.025

Cited by 26 publications

(10 citation statements)

References 34 publications

(50 reference statements)

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“…The same results were observed in Canada, which had a 2 + 1 PCV schedule like that of Peru [63]. A study in Mexico showed PCV13 to have better health outcomes and cost savings than PCV7 and PCV10 [64]. 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].…”

Section: Discussionsupporting

confidence: 57%

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: Discussionsupporting

confidence: 57%

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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“…We can compare our results with other cost-effectiveness studies comparing PCVs, particularly in Latin American countries [53-55]. Muciño-Ortega et al [53] presented an analysis of PCVs for Mexico and showed PCV-13 to be dominant over PHiD-CV and PCV-7.…”

Section: Discussionmentioning

confidence: 52%

“…Muciño-Ortega et al [53] presented an analysis of PCVs for Mexico and showed PCV-13 to be dominant over PHiD-CV and PCV-7. They showed, surprisingly, that PCV-13 (with three additional pneumococcal types) is expected to prevent three times as many deaths as PHiD-CV.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru

Gómez¹,

Tirado²,

Rojas³

et al. 2013

BMC Public Health

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BackgroundThe clinical and economic burden associated with invasive and non-invasive pneumococcal and non-typeable Haemophilus influenzae (NTHi) diseases is substantial in the Latin America and Caribbean region, where pneumococcal vaccines have only been introduced to a few countries. This study analyzed the cost-effectiveness and cost utility of three different pneumococcal conjugate vaccines (PCVs) for Peru.MethodsA Markov model that simulated the disease processes in a birth cohort over a lifetime, within 1,128 month cycles was used to evaluate the cost-effectiveness of 10-valent pneumococcal NTHi protein D conjugate vaccine (PHiD-CV) and 7- and 13-valent PCVs (PCV-7 and PCV-13). Expected quality-adjusted life years (QALYs), cost-savings and incremental cost-effectiveness ratios (ICERs) were calculated.ResultsWithout vaccination, pneumonia was associated with the greatest health economic burden (90% of QALYs lost and 63% of lifetime direct medical costs); while acute otitis media (AOM) was responsible for 1% of QALYs lost and 25% of direct medical costs. All vaccines were predicted to be cost-effective for Peru, with PHiD-CV being most cost-effective. PHiD-CV was predicted to generate 50 more QALYs gained and required a reduced investment (−US$ 3.4 million) versus PCV-13 (discounted data), and was therefore dominant and cost saving. The probabilistic sensitivity analysis showed that PHiD-CV generated more QALYs gained at a reduced cost than PCV-13 in 84% of the simulations and less QALYs gains at a reduced cost in 16%. Additional scenarios using different assumptions on vaccine efficacies based on previous evidence were explored, but no significant change in the overall cost-effective results were observed.ConclusionsThe results of this modeling study predict that PCVs are likely to be a cost-effective strategy to help relieve the epidemiological and economic burden associated with pediatric pneumococcal and NTHi diseases for Peru. PHiD-CV is likely to be a dominant (better health gains at a reduced net cost) intervention compared to PCV-13 or PCV-7. The most significant drivers for these results are the better health and economic profile of PHiD-CV against AOM and its reduced cost per dose available through the PAHO Revolving Fund in the LAC region.

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“…In Latin America there are two important studies with similar results, one in Mexico and another one in Uruguay. The first one concludes that immunization with PCV7, PCV10 or PCV13 would be cost-saving interventions, however, health outcomes and savings of the strategy with PCV13 are greater than those estimated for PCV7 and PCV10 [ 37 ]. The later concluded that there was a significant decline on incidence of hospitalizations for consolidated pneumonia in children younger than 2 years of age, related with a vaccination schedule of 2 + 1 with PCV13 [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of the available pneumococcal conjugated vaccines for children under five years in Colombia

Ordóñez¹,

Orozco

2015

Cost Eff Resour Alloc

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BackgroundPneumococcal diseases in children under five years are common and preventable. In Colombia there are two pneumococcal conjugate vaccines (PCV) that have proved clinical efficacy. The aim was to estimate the cost-effectiveness of 13-valent PCV (PCV13) and 10-valent PCV (PCV10) in terms of prevention of Invasive Pneumococcal Diseases (IPD), radiologically-confirmed pneumonia, and their related mortality, as well as, acute otitis media (AOM) in a cohort of newborns in Colombia.MethodsWe developed an analytical decision tree model with national data including the distribution of pneumococcal serotypes in Colombia between 2009 and 2013. A simulation of vaccination of 90% of newborns in Colombia took place with a time horizon of 5 years. The analysis was done from the Colombian health system perspective. Vaccines efficacy parameters were measured as life-years gained (LYG) and avoided morbidity by pneumococcal diseases; they were determined by a systematic review of literature. A health insurance company provided the costs. A probabilistic and a univariate sensitivity analysis for epidemiological, efficacy and cost parameters were done.ResultsAfter 5 years projection, PCV13 would prevent 437 deaths due to pneumococcal infections versus 321 that would be prevented by PCV10, compared to no vaccination. PCV13 would generate 25 396 LYG, and PCV10 would generate 18 708 LYG. Medical costs avoided would be US$ 19 479 395 for PCV13 and US$ 13 703 271 for PCV10. Compared to no vaccination, PCV13 and PCV10 were cost-effective, with an incremental cost-effectiveness ratio (ICER) of US$ 489.26 and US$ 813.41 per additional LYG, respectively; besides, PCV13 was dominant over PCV10 due to lower costs and better outcomes.ConclusionPCV13 is a cost-saving strategy compared with PCV10, as part of a universal coverage vaccination program in Colombian children under one year. PCV13 is expected to lead to a greater decrement in infant mortality from pneumococcal diseases, and a higher cost saving by preventing more pneumococcal diseases compared with PCV10 in a 5 years projection.

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Evaluación Económica de un Programa de Inmunización Infantil en México Basado en la Vacuna Neumocócica Conjugada 13-Valente

Abstract: In Mexico, immunization strategies based on 7, 10 and 13-valent PCV's would be cost-saving interventions, however, health outcomes and savings of the strategy based on 13-valent vaccine are greater than those estimated for 7 and 10-valent PCV's.

Cited by 26 publications

References 34 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 and cost utility analysis of three pneumococcal conjugate vaccines in children of Peru

Cost-effectiveness analysis of the available pneumococcal conjugated vaccines for children under five years in Colombia

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