Cost-effectiveness analysis of the 10- and 13-valent pneumococcal conjugate vaccines in Argentina |
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Authors: | Urueña Analía Pippo Tomás Betelu María Sol Virgilio Federico Giglio Norberto Gentile Angela Jimenez Salvador García Jáuregui Bárbara Clark Andrew D Diosque Máximo Vizzotti Carla |
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Affiliation: | a Ministerio de Salud de la Nación, Argentina b Hospital de Niños “Ricardo Gutierrez”, Ciudad Autónoma de Buenos Aires, Argentina c Sociedad Argentina de Pediatría d Organización Panamericana de la Salud, Ciudad Autónoma de Buenos Aires, Argentina e Pan American Health Organization, Washington, DC, United States f London School of Hygiene & Tropical Medicine, London, United Kingdom |
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Abstract: | ObjectiveSince the 10-valent pneumococcal conjugate vaccine (PCV-10) and 13-valent pneumococcal conjugate vaccine (PCV-13) were recently licensed for use in Argentina, both vaccines were evaluated to estimate the costs, health benefits and cost-effectiveness of adding a PCV to the routine child immunization schedule.MethodologyThe integrated TRIVAC vaccine cost-effectiveness model from Pan American Health Organization's ProVac Initiative (Version 1.0.65) was used to assess the health outcomes of 20 successive cohorts from birth to 5 years of age. PCV-10 and PCV-13 were each compared to a scenario assuming no PCV vaccination. A 3 + 1 (three doses + booster) schedule and a vaccination price of US$ 20.75 per dose was assumed in the base case for both vaccines.ResultsIntroduction of PCV-13 rather than PCV-10 would increase the number of life years gained (LYG) by at least 10%. The number of LYG (and LYG after adjustment for DALY morbidity weights) was 56,882 (64,252) for PCV-10 compared to 65,038 (71,628) for PCV-13. From the health system perspective, the cost per DALY averted was US$ 8973 and US$ 10,948 for PCV-10 and PCV-13 respectively, and US$ 8546 and US$ 10,510 respectively, after incorporating costs saved by households. When PCV13 was compared to PCV10 directly, the additional benefits of PCV-13 was conferred at a cost of US$ 28,147 per DALY averted. Cost-effectiveness was influenced mainly by vaccine price, serotype replacement, pneumonia mortality and discount rate.ConclusionRoutine vaccination against S. pneumoniae in Argentina would be cost-effective with either PCV-10 or PCV-13. PCV-13, with higher coverage of local serotypes, would prevent more cases of pneumonia, invasive pneumococcal disease, sequelae and deaths with a higher number of LYG and DALYs averted, but PCV-10, due its higher impact in the prevention of AOM, would save more costs to the healthcare system. |
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Keywords: | Pneumococcal conjugate vaccine Cost effectiveness Argentina |
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