Objective
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. / This study was presented at 9th International Symposium of
Pneumococci and Pneumococcal Diseases, Hyderabad, India, March
2014, and supported by the National Council of Science, Technology
and Technological Innovation of Peru (CONCYTEC) and
International Clinical Epidemiology Network (INCLEN Trust) / This study was made possible through the financial support of
the Instituto Nacional de Salud (National Institute of Health, Lima,
Peru) and the PROVAC Initiative of the Pan American Health Organization
(Washington, DC, USA).
| Identifer | oai:union.ndltd.org:PERUUPC/oai:repositorioacademico.upc.edu.pe:10757/582635 |
| Date | 24 November 2015 |
| Creators | Mezones Holguín, Edward, Canelo Aybara, Carlos, David Clark, Andrew, Bess Janusz, Cara, Jaúregui, Bárbara, Escobedo Palza, Seimer, Hernandez, Adrian V., Berhane, Yemane, Vega Porras, Denhiking, González, Marco, Fiestas, Fabián, Toledo , Washington, Michele, Fabiana, Suárez, Víctor J. |
| Publisher | Elsevier B.V. |
| Source Sets | Universidad Peruana de Ciencias Aplicadas (UPC) |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/article |
| Format | application/pdf |
| Source | Universidad Peruana de Ciencias Aplicadas (UPC), Repositorio Académico - UPC |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | http://www.sciencedirect.com/science/article/pii/S0264410X14016922 |
Page generated in 0.0024 seconds