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The cost-effectiveness of a 13-valent pneumococcal conjugate vaccination for infants in England.

Abstract：

BACKGROUND:In the immunisation schedule in England and Wales, the 7-valent pneumococcal conjugate vaccine (PCV-7) was replaced by the 13-valent vaccine (PCV-13) in April 2010 after having been used since September 2006. The introduction of PCV-7 was informed by a cost effectiveness analysis using an infectious disease model which projected herd immunity and serotype replacement effects based on the post-vaccine experience in the United States at that time. AIM:To investigate the cost effectiveness of the introduction of PCV-13. METHOD:Invasive disease incidence following vaccination was projected from a dynamic infectious disease model, and combined with serotype specific disease outcomes obtained from a large hospital dataset linked to laboratory confirmation of invasive pneumococcal disease. The economic impact of replacing PCV-7 with PCV-13 was compared to stopping the use of pneumococcal conjugate vaccination altogether. RESULTS:Discontinuing PCV-7 would lead to a projected increase in invasive pneumococcal disease, costs and loss of quality of life compared to the introduction of PCV-13. However under base case assumptions (assuming no impact on non-invasive disease, maximal competition between vaccine and non-vaccine types, time horizon of 30 years, vaccine price of £49.60 a dose+£7.50 administration costs and discounting of costs and benefits at 3.5%) the introduction of PCV-13 is only borderline cost effective compared to a scenario of discontinuing of PCV-7. The intervention becomes more cost-effective when projected impact of non-invasive disease is included or the discount factor for benefits is reduced to 1.5%. CONCLUSION:To our knowledge this is the first evaluation of a transition from PCV-7 to PCV-13 based on a dynamic model. The cost-effectiveness of such a policy change depends on a number of crucial assumptions for which evidence is limited, particularly the impact of PCV-13 on non-invasive disease.

journal_name

Vaccine

journal_title

Vaccine

authors

van Hoek AJ,Choi YH,Trotter C,Miller E,Jit M

doi

10.1016/j.vaccine.2012.10.017

subject

Has Abstract

pub_date

2012-11-26 00:00:00

pages

7205-13

issue

50

eissn

0264-410X

issn

1873-2518

pii

S0264-410X(12)01463-6

journal_volume

30

pub_type

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