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.
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.
Authors: Jamison Pike; Andrew J Leidner; Harrell Chesson; Charles Stoecker; Scott D Grosse Journal: Appl Health Econ Health Policy Date: 2022-02-09 Impact factor: 3.686
Authors: Bernhard Ultsch; Oliver Damm; Philippe Beutels; Joke Bilcke; Bernd Brüggenjürgen; Andreas Gerber-Grote; Wolfgang Greiner; Germaine Hanquet; Raymond Hutubessy; Mark Jit; Mirjam Knol; Rüdiger von Kries; Alexander Kuhlmann; Daniel Levy-Bruhl; Matthias Perleth; Maarten Postma; Heini Salo; Uwe Siebert; Jürgen Wasem; Ole Wichmann Journal: Pharmacoeconomics Date: 2016-03 Impact factor: 4.981
Authors: Michele R Wilson; Matt Wasserman; Taj Jadavji; Maarten Postma; Marie-Claude Breton; Francois Peloquin; Stephanie R Earnshaw; Cheryl McDade; Heather L Sings; Raymond Farkouh Journal: Infect Dis Ther Date: 2018-11-08
Authors: Lijoy Varghese; Louise Talbot; Andrea Govender; Xu-Hao Zhang; Bruce A Mungall Journal: Appl Health Econ Health Policy Date: 2018-06 Impact factor: 2.561
Authors: Sarah Pugh; Matt Wasserman; Margaret Moffatt; Susana Marques; Juan Manuel Reyes; Victor A Prieto; Davy Reijnders; Mark H Rozenbaum; Juha Laine; Heidi Åhman; Raymond Farkouh Journal: Infect Dis Ther Date: 2020-02-24