Huge impact of assumptions on indirect effects on the cost-effectiveness of routine infant vaccination with 7-valent conjugate vaccine (Prevnar) |
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| Authors: | Mark H Rozenbaum Albert Jan van Hoek Eelko Hak Maarten J Postma |
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| Institution: | 1. Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands;2. Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands |
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| Abstract: | Several recently published European cost-effectiveness studies on the 7-valent pneumococcal conjugate vaccine (PCV-7: Prevnar®) have included net-indirect vaccine benefits for non-vaccine protected groups into their studies, which might be too optimistic an approach given recent data. Net-indirect effects result from herd protection minus serotype replacement effects. In this study we analyze the impact of net-indirect effects in non-vaccine protected groups of 5 years of age and older with updated assumptions regarding epidemiologic data and health care unit costs. Without net-indirect benefits for non-vaccine protected groups included the cost-effectiveness ratio is estimated at €72,360 per QALY. In order to obtain cost-effectiveness ratios below the threshold of €50,000 per QALY – which is in the middle of the range that is often referred to in the Netherlands – the net-indirect protective effect should at least be 16% of which has been observed in the USA after the introduction of PCV-7. |
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| Keywords: | Pneumococcal conjugate vaccine Vaccination PCV-7 Prevnar Cost-effectiveness Herd protection Economics S pneumoniae Pneumococcus Serotype replacement |
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